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The Centers for Disease Control and Prevention reports that alcohol was involved for the driver, the pedestrian, or both in 43 percent of fatal pedestrian crashes nationwide in 2024, and nearly half in 2022.
For anyone researching addiction treatment for themselves or a family member, the overlap between substance use and traffic deaths is a reminder that impairment risk extends well beyond the driver’s seat.
What the New York Study Found
Researchers from the Bureau of Occupational Health and Injury Prevention at the New York State Department of Health and Columbia University analyzed data from the Fatality Analysis Reporting System, a national crash database maintained by the federal government.
Over the three-year study window, 18 percent of pedestrian deaths involved drugs alone, 14 percent involved alcohol alone, and 12 percent involved both.
The study also found that substance-involved deaths were most common between 6 p.m. and 6 a.m., with the highest concentration on Saturday evenings.
Pedestrians who had used drugs were more likely to be struck outside of a marked crosswalk than those who had not, which researchers say points to riskier crossing decisions combined with reduced nighttime visibility.
Men accounted for 63 percent of the deaths, and people age 65 and older made up 34 percent. The authors were careful to note that the presence of a substance does not prove it caused the crash, since testing gaps and incomplete data can both underestimate and misattribute impairment.
How This Compares Nationally
The New York numbers track closely with what federal data shows across the rest of the country. NHTSA’s traffic safety data for 2024 found alcohol involvement in 43 percent of fatal pedestrian crashes, and CDC figures for 2022 put that number closer to 48 percent when accounting for either the driver or the pedestrian testing positive.
Roughly 7,080 pedestrians were killed in traffic crashes nationally in 2024. Most public safety campaigns and enforcement dollars are aimed at impaired driving, while pedestrian substance use gets comparatively little attention or research funding, something both the New York researchers and federal safety officials have flagged as a gap.
What This Means for Addiction Treatment Access
For people already in recovery or considering addiction treatment, these findings are less about assigning blame and more about the everyday risks that come with active substance use, including risks pedestrians may not think about, like judgment and reaction time while walking home after drinking or using drugs.
Addiction treatment that addresses alcohol use disorder and polysubstance use together can reduce these kinds of preventable injuries, not just the more commonly discussed risks like overdose or impaired driving.
The researchers specifically flagged polysubstance use, meaning alcohol combined with drugs, as a particular concern, since combined use is linked to more severe impairment in judgment and coordination than either substance alone.
That is consistent with what addiction treatment providers see clinically: people who use more than one substance often need more comprehensive, coordinated care than a single-substance program can offer.
Exploring Treatment Options
Anyone concerned about their own substance use, or a loved one’s, does not need to wait for a crisis to seek addiction treatment. A few practical next steps:
- Ask a primary care provider or an addiction treatment center about a substance use assessment, especially if alcohol and other drugs are both part of the picture.
- Learn about medication-assisted treatment (MAT) options, which combine FDA-approved medications like buprenorphine or naltrexone with counseling and can reduce cravings and relapse risk.
- Review insurance coverage for addiction treatment, since most major insurance plans are required to cover substance use disorder care under federal parity law.
- Ask about outpatient options if inpatient treatment is not a fit, since evening and flexible scheduling exist for people who need to keep working or caring for family while in treatment.
Rehab.com’s directory includes verified treatment centers that can help evaluate the right level of care based on the substances involved, insurance, and location. Call to speak with a treatment advisor about next steps.
