An NRMA report found close to 0.5 per cent of the 2.8 million tests conducted last year were positive.
That's a significant increase on 0.3 per cent the previous year and the highest rate since 2011.
Last year 54 people died in crashes involving alcohol, an increase of 19 per cent.
In COVID-affected 2020, the number of random breath tests conducted nearly halved.
"Understandably, the random breath testing regime was impacted heavily by COVID for safety reasons but as these statistics show we need to get the testing numbers back up again, especially during the festive season when so many people are attending work and social events," NRMA spokesman Peter Khoury said on Wednesday.
The NRMA believes the state has the capacity to conduct more than seven million tests next year, more than one test for every driver.
The tests should be focused on country roads which accounted for almost three-quarters of alcohol-related fatalities last year, the NRMA said.
There should also be campaigns to highlight the risk drink-drivers have of getting caught and the subsequent penalties.
Most Australians find drink-driving abhorrent, Mr Khoury said, however the report shows a creeping complacency with some drivers.
Police need adequate resources "to tackle drink-driving and those other forms of bad driver behaviours that we know puts the lives of innocent people at risk", he said.
The NSW government is spending $583 million over four years to recruit another 1500 police officers, and the NRMA wants them focused on reducing the road toll.
Last year 297 people were killed on NSW roads.
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