Overall, the picture is one of steady progress, with some SETBACKS. The challenging paradigm, based on the principles of population health, continues to score SUCCESSES through such STRATEGIES as reducing the legal blood alcohol concentration. General deterrence, especially utilizing RANDOM enforcement methods, has achieved permanent reductions in alcohol-related crashes, as has administrative license revocation. Treatment combined with license suspension and ignition interlocks reduce recidivism and accidents. Tougher penalties, the major emphasis of the dominant paradigm, show no promise at all.

The challenges include MAINTAINING the deterrent impact of random enforcement; finding long-term ways of dealing with hard-core offenders; optimizing the use of alcohol and driving controls in politically acceptable ways; and maintaining political and media interest in the drinking and driving problem in the face of stiff competition from other social issues. The fact that drinking and driving declined in most countries in the latter part of the twentieth century, despite wide variations in prevention strategies, suggests that within the challenging paradigm there are many pathways to a safer motoring environment


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