Random testing of drivers for mood-altering drugs and substances is one of a number of measures which should be introduced as soon as possible in an attempt to improve road safety, the Irish Medical Organisation has said.
The doctors' union also wants a lowering of permitted alcohol limits while driving so that they are brought more into line with EU norms.
It has also called for non-dual-carriageway roads to have passing lanes at five-mile intervals.
The measures are part of a 20-point plan published by the IMO in a position paper on road safety.
Dr Joe Barry, one of the authors and past president of the IMO, is to meet the Department of Transport shortly to discuss the paper's contents.
There were 379 deaths on Irish roads last year, and the IMO paper says 90 per cent of road deaths and injuries are caused by road-user error, while less than 4 per cent of crashes are due to mechanical or other defect.
Dr Barry said the two main causes were alcohol and speed.
"It seemed like penalty points would address the speeding issue, but the perception is now that you are not really going to get caught," he said.
The single most important step forward the Government could take to improve road safety was to introduce random breath-testing and this should be done as a matter of urgency, he said.
Among the other changes he is seeking in an attempt to curb carnage on Irish roads are: