When one thinks about alcohol-related deaths, fatal crashes often come to mind.

Take the case of Brianne Colonna, for example. The then-27-year-old was drunk and driving 60 mph through Waterford in December 2016 when she crossed the double-yellow line and slammed into another vehicle, killing 24-year-old Stephanie Turowski of Waterford, an aspiring teacher.

Colonna, a licensed clinical social worker whose sister died by heroin overdose in February 2018, offered a weeping apology when she was sentenced to 7½ years in prison in December last year, saying she wished she, herself, had died instead.

In handing down her sentence, Judge Kevin P. McMahon said drunken driving cases are the worst cases because everybody involved loses.

"Welcome to my world of drunk driving death," he said. "It sucks."

But fatal crashes are just one part of the story. Per the Centers for Disease Control and Prevention, alcohol kills about 88,000 people annually — more than fatal overdoses on all other drugs, combined — through cancer, liver cirrhosis, pancreatitis, suicide and other ways.

Yet Jane Ungemack, an assistant professor in the Department of Community Medicine and Health Care at the University of Connecticut, said the topic doesn’t always garner the attention it should.

“Because we’re so involved in fighting the opioid issue, I’m afraid we're forgetting about things like alcohol and that it’s dangerous,” said Ungemack, who has been doing research and tracking data for state agencies since the 1990s. “We’re not appreciating that we’re living with another, more prevalent potential issue.”

While some studies have found alarming increases in alcohol use in the United States since the early 2000s, especially among women, available data indicate Connecticut’s rate has remained about the same.

In the biennial National Survey on Drug Use and Health, for example, 77.4 percent of Connecticut adults reported using alcohol in the past year in 2016-17, compared to 81.5 percent in 2004-05. Ungemack said men drove the decrease; the rate for women has been relatively flat.[naviga:img hspace="5" vspace="5" border="0" height="631" width="800" align="middle" alt="" src="https://www.theday.com/assets/news2019/graphs/alcohol-use-ct-adults.jpg"/]

Diana Shaw, public information officer for the state Department of Mental Health and Addiction Services, said alcohol-related admissions for treatment also have been steady in the public sphere.

Per DMHAS’s annual statistics, people report alcohol as their drug of choice when being admitted for state mental health or substance abuse care about 30,000 times a year.

“Alcohol has historically been the primary drug of choice among people in our system,” Shaw said. “We saw this surge in opioid admissions and overdose deaths, and that has definitely garnered attention. But alcohol has always been a problem. It hasn’t gone away.”

Ungemack said the best numbers are among youth, who are reporting about half as much underage drinking as they did 10 years ago. She credits public education campaigns and policies such as the “social host” law, which makes it so anyone of any age can be liable if youth are caught drinking in their presence, for the drop.

But Ungemack said the consistency in Connecticut’s numbers isn’t necessarily cause for celebration.

“Connecticut’s rates of drinking are still higher than the national average — even with the slight reductions,” she said.

Ungemack said the state’s “overwhelmingly” white and well-educated population, along with its higher proportion of women in the workforce, contributes to the high rates.

The state also has the nation’s highest percentage of alcohol-impaired crash deaths, the National Highway Traffic Safety Administration has reported. Of 278 crash deaths in 2017, 43 percent were related to alcohol-impaired driving. The national average in 2017 was 29 percent.

Ungemack said lackluster public transportation may compel more people to drive after drinking, and traffic congestion may make them more likely to get into a crash than if they were on a rural Midwest road, for example.

Connecticut sees about 3,000 substance-impaired crashes a year, The Day found in an analysis of the UConn Connecticut Crash Data Repository.[naviga:img hspace="5" vspace="5" border="0" height="380" width="630" align="middle" alt="" src="https://www.theday.com/assets/news2019/graphs/undertheinfluence-accident-totals-by-severity.jpg"/]

While the number of such crashes has risen since 2009, the likelihood of a fatality in one actually has gone down. Notably, the number of women who were under the influence when they crashed increased by 30 percent over the past 10 years compared to a 17 percent increase among men.[naviga:img hspace="5" vspace="5" border="0" height="483" width="750" align="middle" alt="" src="https://www.theday.com/assets/news2019/graphs/accidents-under-influence-gender.jpg"/]

“In a perverse way, equality has meant we are more likely as women to be sharing many of the same risks and consequences that men experience,” Ungemack said.

Amy Parmenter, spokeswoman for AAA of Greater Hartford, said her agency routinely reviews data and will look more closely to see if women are a group it should target with messaging around impaired driving. “If a specific market can be identified as growing or more problematic than another group, another demographic, that’s going to be valuable information for us to have,” she said.[naviga:img hspace="5" vspace="5" border="0" height="452" width="750" align="middle" alt="" src="https://www.theday.com/assets/news2019/graphs/undertheinfluence-accidents-perc-by-severity.jpg"/]

Bob Garguilo, executive director of the Connecticut chapter of Mothers Against Drunk Driving, said his team has noticed more and more people attending MADD-CT’s victim impact panels, which can be court-mandated after a DUI. He said the panels, in which offenders hear in person from victims of DUI, are hosted once a week in several locations across the state.

“We’re seeing well in excess of 100 people each week,” he said. “It’s alarming, but it shows our partners in the law enforcement community are doing their job.”

Garguilo said while MADD has helped cut nationwide DUI-related deaths by 53 percent since 1980, 10,874 deaths still were attributed to DUI in 2017.

“People aren’t getting it,” Garguilo said. “Everyone thinks they can drive. ‘I thought I could handle it.’ That’s what we hear the most.”

“But even one drink can affect vision and decision-making,” he said. “We need to change the culture to get people to understand it’s not the right thing to do — especially when there are so many ways to be transported back home.”

l.boyle@theday.com