New federal crash data from 2019 through 2023 shows that some U.S. cities carry a much heavier burden of deadly drunk driving than others. Using NHTSA’s Fatality Analysis Reporting System (FARS), a new analysis of the 300 largest cities in the country ranks the Top 100 by the rate of drivers in fatal crashes with a blood alcohol concentration (BAC) of 0.08 or higher. Texas is heavily represented on that list, from very high rate smaller cities like Odessa and Beaumont to large metros like Dallas, Houston, San Antonio, Fort Worth, and Arlington. Here we’ll break down the numbers and explain what they mean for families on Texas roads.
How We Ranked U.S. Cities By Fatal Drunk Driving Accidents
To make this study useful for everyday drivers, the rankings needed to be simple to understand and fair to cities of different sizes. That is why the focus is on rates per 100,000 residents instead of raw counts. A smaller city with fewer deaths can still be much more dangerous per person than a larger metro.
At the heart of this analysis is FARS, a nationwide census of fatal motor vehicle crashes maintained by the National Highway Traffic Safety Administration. FARS gathers detailed information on every fatal crash in all 50 states, the District of Columbia, and Puerto Rico, including driver BAC levels where test results are available.
How Did We Identify the U.S. Cities With the Highest Rate of Fatal Drunk Driving Crashes?
The rankings are based on the 300 largest U.S. cities by population. For each city, analysts pulled FARS records from 2019 through 2023 and counted drivers involved in fatal crashes with a BAC of 0.08 or higher, the legal limit for alcohol impaired driving in most states. Those totals were then converted into a rate per 100,000 residents using 2023 population estimates so that cities of different sizes could be compared on equal footing. Finally, the Top 100 cities with the highest per capita rates were selected for closer review, including both smaller high risk communities and large metros with many deaths.
What Does BAC 0.15 Mean and Why Is It Considered Aggravated Drunk Driving?
BAC, or blood alcohol concentration, measures the amount of alcohol in a person’s bloodstream. In most of the United States, a driver is considered legally impaired at 0.08 grams of alcohol per deciliter of blood, which is the standard used for DUI charges and for defining “alcohol impaired driving” in federal statistics. A BAC of 0.15 or higher reflects much heavier drinking and is often treated as an aggravated level of impairment that sharply increases crash risk. In this study, analysts looked at both drivers at or above 0.08 and the subset at or above 0.15. That second group helps show how many fatal crashes involve drivers who are not just slightly over the limit, but extremely intoxicated.
Key Findings From the Top 100 High Risk Cities
When you step back and look at the Top 100 cities together, a clear and troubling picture emerges. Across those 100 communities from 2019 through 2023, there were 8,971 drivers in fatal crashes with BACs of 0.08 or higher and 6,000 with BACs of 0.15 or higher. Using population weighted rates, that works out to about 26.3 drunk driving deaths per 100,000 residents across the Top 100 group, which is already well above typical national averages.
Most of the very highest rates appear in smaller and mid sized communities where even a few dozen fatal crashes translate into very high per person risk. At the same time, large metro areas with lower rates can still have large numbers of deaths simply because so many people live and drive there. A simple table that lists the overall Top 10 cities by rate, plus their total alcohol impaired fatal crashes, would give readers a quick visual sense of this imbalance.
Which City in the U.S. Has the Highest Rate of Fatal Drunk Driving Accidents?
In both earlier work covering 2018 through 2022 and this newer 2019 through 2023 analysis, Odessa, Texas, stands out at or near the very top of U.S. cities by per capita drunk driving death rate. In the current data window, Odessa’s rate is roughly 60.1 drivers in fatal crashes with BAC 0.08 or higher per 100,000 residents, far above the already elevated Top 100 average. Other high risk communities, including Beaumont and Lubbock, also appear near the top, reminding us that the worst per capita risk often shows up in smaller cities rather than the biggest metros.
How Many Drunk Driving Fatalities Happen Each Year in the United States?
Nationally, alcohol impaired driving remains a major cause of traffic deaths. Federal Traffic Safety Facts reports show that 13,524 people were killed in alcohol impaired driving crashes in 2022, accounting for about 32 percent of all U.S. traffic fatalities that year. Early 2023 data show 12,429 alcohol impaired driving deaths, or about one person killed every 42 minutes, and around 30 percent of all traffic deaths. The Governors Highway Safety Association has highlighted that drunk driving deaths increased about 33 percent between 2019 and 2022 before recent signs of leveling off, reflecting the combined impact of risky driving during and after the pandemic.
Why Texas Stands Out in the Rankings
Within this Top 100 list, Texas stands out in a way that is hard to ignore. Out of the 100 cities in the study, 22 are in Texas. Taken together, those 22 cities account for about 31 percent of the total population covered by the Top 100 group, yet they are associated with an even larger share of the deaths.
Across 2019 through 2023, those Texas cities make up roughly 2,895 of the 8,971 drivers in fatal crashes with BAC 0.08 or higher, which is about 32.3 percent of the total. They also account for 1,971 of the 6,000 BAC 0.15 plus drivers in the Top 100, or about 32.9 percent. That means Texas is not only overrepresented in drunk driving deaths overall, it is also overrepresented in the most extreme, heavily intoxicated crashes.
Why Do So Many Texas Cities Rank in the Top 100 for Drunk Driving Deaths?
Several factors help explain why so many Texas communities appear in this high risk group. Texas has a large and fast growing population, many long highway corridors that connect cities and suburbs, and busy nightlife and entertainment districts where late night drinking is common. At the same time, long travel distances and limited transit options in some areas can make people more likely to drive after drinking when they should not. When you look at the numbers per 100,000 residents rather than raw counts, cities like Odessa, Beaumont, Lubbock, Dallas, and Midland rise to the top because fatal drunk driving crashes are both frequent and concentrated relative to their size. Texas agencies and safety advocates have been sounding the alarm for years, but this new multi year window confirms that the problem runs deep.
How Does the Rate of Drunk Driving Deaths in Texas Compare to the National Average?
Within the Top 100 sample of cities, the overall population weighted average rate is about 26.3 drunk driving deaths per 100,000 residents. The Texas subset of those cities has an average of about 27.1 deaths per 100,000 residents. That gap might seem small on paper, but it means that even within a group of already high risk cities, the Texas cities are slightly more dangerous. In some Texas communities the contrast is sharper. Odessa is around 60.1 deaths per 100,000, Beaumont around 40.0, Lubbock roughly 38.4, Dallas about 36.1, and Midland about 34.4, which are rates more than double or even triple what many U.S. cities experience.
Smaller and mid-sized Texas cities like Tyler, Abilene, Irving, Mesquite, Waco, Conroe, Killeen, Richardson, Edinburg, and Arlington often fall in the 19 to 24 deaths per 100,000 range. That is still very high compared to national norms, and in several places, including Midland, Odessa, Edinburg, Lubbock, and Beaumont, roughly 70 to 80 percent of BAC 0.08 plus deaths involve drivers with BACs of 0.15 or higher. That level of impairment increases crash severity and makes the human cost even more devastating.
What These Numbers Mean for Fort Worth, Arlington, San Antonio, and Other Texas Communities
For families in Fort Worth, Arlington, and San Antonio, these statistics are not just abstract figures on a chart. Each one represents a person whose life ended too soon and a network of loved ones who are left to navigate grief, medical bills, and confusing insurance questions. Fort Worth and San Antonio sit close to the Texas Top 100 average, while Arlington’s rate is somewhat lower but still firmly in the high risk band. In all three metro areas, drunk driving crashes cluster around major corridors, entertainment districts, and weekend late night hours.
Patterson Law Group has already invested in research about drunk driving in Texas, including which counties have the highest fatality rates and what factors increase the risk of a Fort Worth car accident. That work and this new city level analysis both point to the same reality. Drunk driving crashes are preventable, yet they continue to harm Texas families at a troubling rate.
In the background, national data show that alcohol impaired deaths rose sharply from about 10,196 in 2019 to 13,524 in 2022 before early 2023 figures showed a modest decline. Campaigns like “Drive Sober or Get Pulled Over,” designated driver programs, and rideshare apps have made a difference, but they have not eliminated the problem.
What Do These Drunk Driving Numbers Mean If You Live in Fort Worth, Arlington, or San Antonio?
If you live in one of these cities, the data suggests that you share the road with a higher than average number of impaired drivers, especially at night and on weekends. It also suggests that many of the worst crashes involve drivers with BAC levels far above the legal limit, which can lead to more severe injuries and more complex legal questions. For families in Fort Worth, Arlington, and San Antonio, this means that everyday decisions, such as planning a safe ride home from a bar or watching for impaired drivers on major corridors, have real life consequences. It also means that when a drunk driving crash happens, it is rarely a “freak accident” and more often the predictable result of choices and systems that failed to prevent a predictable harm.
What Can I Do If a Drunk Driver Causes a Serious Crash in Fort Worth or Another Texas City?
After a serious drunk driving crash, your first priority is safety and medical care. Call 911, cooperate with law enforcement, and accept transport or follow up treatment so that your injuries are documented. If you can safely do so, collect contact information, photos of the scene, and details about potential witnesses or nearby businesses that might have video footage. In the days that follow, consider speaking with a drunk driving accident lawyer who can explain your rights, help you deal with insurance adjusters, and determine whether dram shop claims might apply against a bar or restaurant that overserved the driver.
If you have lost a loved one or suffered life changing injuries in a drunk driving crash in Fort Worth, Arlington, San Antonio, or another Texas community, you do not have to walk through it alone. Patterson Law Group offers free consultations, listens to your story, and helps you understand what accountability and recovery could look like for your family. Your journey to resolution can start with a single conversation.
