Alcohol consumption poses a significant public health challenge, presenting serious risks to individual health and contributing to over 700 daily road fatalities worldwide. Digital interventions can play a crucial role in reducing these risks. However, reliable drunk driving detection systems are vital to effectively deliver these interventions. To develop and evaluate such a system, we conducted an interventional study on a test track to collect real vehicle data from 54 participants. Our system reliably identifies non-sober driving with an area under the receiver operating characteristic curve (AUROC) of 0.84 ± 0.11 and driving above the WHO-recommended blood alcohol concentration limit of 0.05 g/dL with an AUROC of 0.80 ± 0.10. Our models rely on well-known physiological drunk driving patterns. To the best of our knowledge, we are the first to (1) rigorously evaluate the potential of (2) driver monitoring cameras and real-time vehicle data for detecting drunk driving in a (3) real vehicle.

Excessive alcohol consumption causes disability and death. Digital interventions are promising means to promote behavioral change and thus prevent alcohol-related harm, especially in critical moments such as driving. This requires real-time information on a person’s blood alcohol concentration (BAC). Here, we develop an in-vehicle machine learning system to predict critical BAC levels. Our system leverages driver monitoring cameras mandated in numerous countries worldwide. We evaluate our system with n = 30 participants in an interventional simulator study. Our system reliably detects driving under any alcohol influence (area under the receiver operating characteristic curve [AUROC] 0.88) and driving above the WHO recommended limit of 0.05 g/dL BAC (AUROC 0.79). Model inspection reveals reliance on pathophysiological effects associated with alcohol consumption. To our knowledge, we are the first to rigorously evaluate the use of driver monitoring cameras for detecting drunk driving. Our results highlight the potential of driver monitoring cameras and enable next-generation drunk driver interaction preventing alcohol-related harm.