First, the problems of alcohol and road accidents and alcohol-impaired driving are examined, taking into account the social and cultural context in which they arise and persist, including the costs and benefits of both alcoholic beverage consumption and motor vehicle transportation. The effectiveness of societal response to these problems then is assessed. It is suggested that current efforts have been less than optimally effective as a result of a lack of cross-fertilization between and among the research and the countermeasures (e.g., education, traffic safety, treatment, law enforcement) communities. Also cited are insufficient funding of programs and inadequate program evaluation and application of evaluation results. Finally, future strategies and priorities are delineated with emphasis on the need for a major strategic, coordinated, long-term approach that integrates action, evaluation, and research components. Appendixes include tabular data and a listing of alcohol countermeasures. 516 references.