Introduction. The ever-increasing global road traffic accidents is caused by several risk factors: human factors, vehicle factors, and road environmental factors. In the Philippines, 12,000 road users die annually due to road crashes and almost one-third are alcohol-related crashes.

Objectives. This study aims to investigate the effects of suspected alcohol intoxication on the severity of injuries among drivers and passengers in a major urban region in the Philippines using the Metro Manila Accident Recording and Analysis System (MMARAS) of the Metropolitan Manila Development Authority from 2005 to 2020.

Methods. The Metro Manila Accident Recording and Analysis System (MMARAS) was used to determine the data on trends and association for alcohol-related road crashes, while descriptive and inferential statistics such as logistic and multinomial regression were used to determine trends and associations.

Results. Suspected alcohol intoxication road crash cases in Metro Manila have decreased from 45 cases in 2005 to 31 cases in 2020. The year 2011 recorded the highest cases of alcohol-suspected road crashes. The years 2010, 2011, and 2012 recorded the highest number of driver's death while 2005, 2006, 2014, and 2019 recorded higher deaths for passengers. Cars and motorcycles are the most commonly involved vehicles in alcohol-suspected road crashes, while Quezon City (n=307) and Marikina City (n=267) are the common places of incidence for drunk-driving accidents. On the other hand, alcohol intoxication increases the risk of driver's death (OR=9.16; 95% CI [5.388-15.574]) and injury (OR=5.22; 95% CI [4.487-6.074]). While intoxicated, hitting an object (OR = 12.557; 95% CI [1.478-106.694]) and truck collisions (OR=7.176; 96% CI [1.261-40.817]) can increase the risk for driver's death. Meanwhile, side swipe (OR=2.330; 95% CI [1.029-5.277]) and angle impact (OR= 7.972; 95% CI [1.804-35.227]), increase the odds for driver injuries.

Conclusion. Suspected alcohol intoxication road crashes can be prevented; however, a collaborative effort is needed. The government is responsible for road safety education as well as effectively enforcing road safety-related laws, while the road users shall use the roadways responsibly.