Enforcement of drunken driving laws in cases involving injured intoxicated drivers

Study objective: To determine the frequency of driving while impaired (DWI) charges among alcohol-intoxicated drivers injured in motor vehicle crashes (MVCs) and any differences in the group of those charged compared with those not charged. Methods: We performed a retrospective analysis of linked data from medical and judicial sources. Our setting was an urban emergency department of a trauma center serving a population of 1 million. We studied consecutive drivers injured in MVCs over a period of 15 months who had measured serum ethanol (BAG) levels of 100 mg/dL or higher. BAG, Trauma Score (TS), demographics, and crash data were linked to court records of charges, outcome, and prior convictions. The group of individuals who were charged with DWI were compared with those who were not charged. Results: One hundred eighty-seven patients were studied; 53 (28%) were charged with DWI, and 32 (17% of total) were convicted. Two (7%) of 29 patients with severe injuries, 9 (28%) of 32 with moderate injuries, and 42 (33%) of 126 with nonsevere injuries were charged (P=.004). Eighteen (16%) of 112 patients with no prior convictions were charged; 20 (56%) of 36 patients with one, 11 (52%) of 21 with two, 3 (25%) of 12 with three, and 0 of 5 with four or more prior DWI convictions were charged (P<.001). There were no significant differences in BAG, demographics, or other measures between the two groups. Conclusion: Alcohol-impaired drivers who require ED treatment for injuries sustained in an MVC are infrequently charged with DWI. The likelihood of a DWI charge diminishes with increasing severity of injury. Repeat offenders are charged more often, but the frequency of charges does not increase with increasing number of prior DWI convictions.