After decades of public safety campaigns focused on drinking and driving, it may be time to focus on the seventh leading cause of injury-related death, according to Bureau of Occupational Health and Injury Prevention at New York State Department of Health and Columbia University scholars looking at New York State. That's about 15,000 pedestrian injuries annually.
Data from the Fatality Analysis Reporting System national database includes deaths that occur within 30 days of the crash as well as alcohol and drug test results reported as part of post-mortem examinations. In the years 2018 to 2020 inclusive, there were 771 pedestrian deaths in New York State that resulted from collision with a vehicle. The presence of alcohol, drugs, or both was noted in 338 of the pedestrians who died, 43.8 percent.
It's good they weren't driving, until self-driving cars become the norm it's important that impaired people not drive, but it's still reasonable to not make drivers suffer the trauma of hitting someone, and have less loss of life.
Some 18 percent of the pedestrian deaths involved drugs alone. Alcohol use, a blood alcohol concentration of 0.01 percent, was recorded in 14 percent. A large concern was that 12 percent involved both alcohol and drugs. Not just because of the deaths, but that alcohol and drug co-use causes more severe impairments in cognitive function and neurocognitive deficits compared even with single drug use.
It seems to get worse with age and mostly to men. Men were 63 percent of the fatalities while people aged 65 and older were 34 percent - which means their deaths are 100 percent higher than their population representation. Most, 57 percent, did not have cultural factors listed but 58 percent of the data showed men who identified as hispanic. As expected, most were at night and on the weekend. Deaths were most likely to be on a road and not in a crosswalk when struck.
Even if impairment is not solely responsible for the fatality or directly contributed to the crash. Impaired decision making and walking on public roads matter as well.
Citation: Jancarlos Guzman, Matthew F Garnett, Emilia Pawlowski, Joyce C Pressley, Leah M Hines, Jennifer Hogan, Michael Baueral, 'Substance use among fatally-injured pedestrians in New York State, USA: a retrospective analysis', Injury Prevention Published Online First: 13 July 2026. doi: 10.1136/ip-2025-045980
