Crash report and blood alcohol concentration (BAC) data were linked for 109 injured driver/passenger pairs admitted to a Level I trauma center. Among those occupants, 47 drivers (43%) (mean BAC, 147 mg/dl) and 45 passengers (41%) (mean BAC, 127 mg/dl) were BAC+. No occupant was BAC+ in 57 crashes (52%); both were BAC+ in 40 (37%); and only one was BAC+ in 12 (11%). When both occupants were BAC+, the driver had the higher BAC in 68% of cases, and when one was BAC+, it was the driver 58% of the time. In 6 additional alcohol-related crashes with one driver and two passengers, the "wrong" occupant was driving on 5 occasions. Hence, in the 58 crashes involving BAC+ occupants, the least appropriate occupant was driving 67% of the time.