• At 80mg/100ml (or 0.08%) England, Wales, and Northern Ireland have the highest BAC limit in all of Europe. Drivers who drink up to this limit are 6 times more likely to be involved in a fatal crash than those with 0mg/100mls.
• Laboratory studies show that impairment in critical driving functions begins at low BAC levels, and most subjects are significantly impaired at 0.05% BAC.
• Studies from the US have shown that reducing the BAC limit from 0.08% to 0.05% is effective in preventing collisions.
• Research shows that new drivers are three times more likely to be injured in a crash if they have been drinking alcohol.
• According to 2010 National Institute for Health and Care Excellence (NICE) estimates, which modelled collisions in England and Wales based on research conducted in Europe and Australia, more than 150 lives a year could be saved by lowering the drink drive limit to 0.05%. At minimum, the Institute of Alcohol Studies estimated in 2020 that 25 lives per year could be saved.

• The European Transport Safety Council 2018 report and 2022 report provided examples of progress in reducing drink driving rates across the European Union. Many of the examples highlight that success in reducing drink driving rates combines lowering the BAC limit with other policy measures, such as increasing enforcement and education.
• There is evidence from a number of countries, including Australia, Brazil, France, Japan, Sweden, Lithuania, Estonia, and Switzerland where a reduction in BAC limit has contributed to a reduction in fatal collisions.
• Scotland lowered their BAC limit to 0.05% in 2014 without sufficient attention or focus on the wider measures. This resulted in a lack of long-term change in the reduction of drink driving. The experience in Scotland shows us how important it is to implement accompanying measures of enforcement and educating the public of the new limits.

• A Parliamentary Advisory Committee for Transport Safety (PACTS) report from 2020 highlights the importance of road policing in improving road safety and the ‘fatal four’ offences, which includes driving under the influence of alcohol or drugs. Findings show that where enforcement has been increased, compliance with traffic laws has improved and casualties have decreased.

• A 2016 systematic review of studies indicated that under some conditions, and with careful design and good execution, and preferably with a focus on positive messages, mass-media campaigns can successfully contribute to the reduction in alcohol impaired driving.
• A 2020 PACTS report flags that there is evidence which show that media campaigns, in combination with other policy measures such as increased enforcement, can reduce the number of drink drive casualties and deaths.
• Evidence shows that untargeted campaigns often fail to resonate with those perpetuating those acts. For example, research found that in the Think! Drink Drive campaign called ‘Personal Consequences’, launched in 2007 and targeted at 17-29 year old males, previous adverts failed to resonate with that group largely because they felt that the messages were targeted at the ‘drunk-drivers’ which they did not associate themselves with.
• Evidence from THINK! In their Mates for Life campaign shows that media campaigns can be effective in encouraging a target audience - in this case young men - to intervene and prevent drink driving amongst their friends. Their 2022 campaign saw 7 in 10 of their audience reporting taking action after seeing their content, including stopping a friend from drinking before driving.

• Alcohol treatment services have a success rate of around 60%. But not everyone who needs treatment can access it. 82% of dependent drinkers were not in treatment in 2018-2019. And only 23% of people in alcohol treatment services are referred to treatment from health services. This highlights the need for greater investment in training in early identification and brief interventions for healthcare workers – as research showed that healthcare workers assessing patients often fail to spot early signs of problem drinking.
• Alcohol treatment services benefit not just the individuals who receive treatment but wider society. According to a PHE review (2018), every £1 invested in alcohol treatment yields £3 of social return in England. This increases to £26 over 10 years.
• In England, increased investment in alcohol and drug treatment in the early twenty-first century, was associated with improved treatment access, reduced waiting times, improved service quality and a reduction in related harm. This is sited by multiple sources including Public Health England.
• The Public Health Grant in England has been cut by more than a fifth in real terms per person since 2015. Following the Black Review, the government announced an additional £421 million for drug and alcohol services in 2023/24 and 2024/25 in England. This means that total local authority funding for treatment will have increased 40% between 2020/21 and 2024/25, without accounting for inflation or population growth. However welcome this addition is, this funding is short-term and makes it hard to plan for long term investments and strategy.
• There are also significant shortages of trained staff in addiction treatment services. A 2020 Royal College of Psychiatrists report found that addiction psychiatrists training posts had been decreasing in the last decade, and could be wiped out in the next. Though an issue across the UK, the situation is worse in England. Those in addiction psychiatrist roles only make up 1% of the alcohol and drug treatment workforce in England.
• The voluntary sector has stepped up to fill the gaps in alcohol and drug treatment services. For example, in England, the voluntary sector makes up about 78% of the WTE alcohol and drug treatment services workforce, with 12% of the whole workforce being unpaid volunteers.
• Research from 2022 showed that every £1 invested in the NHS generates £4 of economic growth. The study pointed out that investment in the primary care workforce and reduced A&E attendances and urgent admissions would have the greatest effect on the wider economy.

These include alcohol and drug education programmes:

• Non-attendees to drink-driving rehabilitation courses are over twice as likely to commit a new drink-driving offence within three years, so by offering high-risk drug-driving offenders the same support, Government hopes to bring down the number of repeat offenders.
• A systematic review from 2021 showed that some education programmes have the capacity to positively change alcohol-related behaviour, although quality of the programmes affect outcome. Hence, programmes should be designed alongside health education/promotion models and best practice recommendations.

And mandatory labelling of alcohol products:

• Research has found that all enhanced label designs for alcohol products improved knowledge of the guidelines compared to the standard label, and that the reported motivation to drink was slightly decreased. Though labelling does not necessarily change behaviour, it can inform choices and help provide accurate information and clear advice about the health risks of alcohol.
• A 2020 Institute of Alcohol Studies review of international evidence shows that introducing health information on alcohol products increases consumer knowledge and awareness of the adverse health impacts of alcohol. The review stressed that a mandatory system is necessary. This is because voluntary labelling schemes, where industry can choose whether to comply and to what extent and quality, are less effective at reaching the standards required to inform and protect consumers where health is concerned.

The public supports lowering the BAC limit:

• Almost 80% of the UK public support lowering the drink-drive limit.

The public supports mandating proper labelling and limiting alcohol advertising:

• AHA and YouGov research shows that 70% of adults would support health warnings on alcohol products.
• A European consumer survey revealed that 81% of UK participants believe that alcohol labels do not provide sufficient health-related information.
• A 2023 survey found that 54% of the British public would support not allowing alcohol advertising in public spaces. The most popular measure was including a health warning on all alcohol advertising to communicate the risks associated with drinking alcohol, supported by 66 percent of respondents.

The public supports investment into national and local health services:

• The Health Foundation and Ipsos partnered to deliver research that found that 77% of the public believe that the NHS is crucial and everything must be done for it to be maintained, and 71% would support additional government spending and investments.

• In Great Britain, around 5% of all reported road traffic collisions in 2021 involved at least one driver or rider over the legal alcohol limit – a rate that has seen no improvement since 1990.
• There has been no sustained decrease in the number of those killed or seriously injured (KSI) drink drive casualties between 2013-2021. There was a sharp decline in 2020 (due to the Covid-19 pandemic), but in 2021 that number increased to pre-2020 average levels. The percentage as a proportion of KSI casualties has increased since 2014 (from 5% to 7%).
• Great Britain had 260 drink drive fatalities in 2021, an 11% increase from 2013, and the highest number since 2009.
• 17% of all road deaths in Great Britain occurred where a drink driver was involved in the collision. Analysis conducted in 2014 estimates that 60% of those killed or injured in drink-drive collisions are those other than the driver.
• A 2021 PACTS report stated that 17% of drink drive offences are committed by a reoffender, and a significant number of reoffenders have alcohol and mental health issues.

Drink driving causes an avoidable strain on the NHS and ambulance services and the wider economy

• The latest available data estimated that drink driving costs Great Britain £23.5 million in medical and ambulance costs.
• The latest available data estimated that, in total, drink driving costs Great Britain £800 million each year.

• Drug-driving has been on the increase in recent decades in Great Britain. According to the Department for Transport, the number of deceased drivers with drugs detected in fatal collisions has increased by over 60% from 2014 to 2019. Whilst this could reflect changes to testing abilities and record keeping, the increase is broadly in line with that for the ‘impaired by drugs’ contributory factor recorded in STATS19*.
• In 2021, the Department for Transport statistics showed that the number of casualties in relation to drug-driving was 2,500. This is a surge of 260% since 2012. Between 2014 and 2021, 64% of casualties in collisions where an impairment drug was detected were fatalities. 91% of those fatalities were drivers with drugs in their system, showing that those most affected were the drug drivers themselves.
• A 2021 Parliamentary Advisory Committee for Transport Safety report on drug driving found that nearly half (44%) of drug drive offences are committed by a reoffender.
• Illegal drugs played the largest role in drug-driving cases in all age groups. The 5 most common detected drugs in general police drug driving tests were cocaine, benzoylecgonine, cannabis, morphine, and ketamine. Only drivers over the age of 70 had medicinal drugs detected more than illegal drugs.

* Statistics on road safety in Great Britain are mostly based on personal-injury collisions reported to the police in the STATS19 data collection.

• A 2021 PACTS report on drink driving showed that levels of police enforcement on the road in the UK have decreased by 63% since 2009.
• The police may randomly stop a vehicle in order to ascertain whether or not the driver has alcohol or drugs in their system, but they cannot randomly require a driver to comply with any tests. This does not include preliminary roadside alcohol breath tests, as those can be administered as a matter of routine if they reasonably believe a person was drinking at the time of a collision on the road or public spaces.
• The police can test for cannabis and cocaine at the roadside, but can only screen for other drugs at a police station. The 2021 PACTS report on drug driving flagged that blood samples had to be taken by a healthcare practitioner and a healthcare practitioner in charge of the case had to approve the specimen being taken. Police officers reported that, in cases where there was no force healthcare professional at the station, this system could ‘require taking people arrested on suspicion of drug driving to A&E where, under the triage systems most hospitals operate, they will be allocated a doctor but it can be some time before the doctor is able to see the patient.’ Hence, also adding to the burden on A&E services.
• Enforcement of drug driving laws varies dramatically across the UK, with some police forces convicting 10 times more drug drivers than others. Additionally, some police forces have as many convictions for drug driving as drink driving, while in other forces patrols are rationed to a single drug testing kit which results in officers only testing where there is clear evidence of drug use. They also raise significant concerns about the amount of time taken for laboratories to process blood tests and the length of the court process in general.
• An added complication in the case of a collision attended by ambulance or paramedics is the need to determine which drugs found in the body were administered by paramedics on scene, rather than taken by the user before a collision.