Driving Under The Influence Offenses Research Articles

Long-term effectiveness of the alcohol ignition interlock programme: A retrospective cohort study in the Netherlands

This article provides an evaluation of the long-term effectiveness of the Alcohol Ignition Interlock Programme (AIIP) on recidivism. A retrospective cohort design was used to compare the known reoffending behaviour of 1676 AIIP participants with that of 907 persons in a control group, consisting of offenders who committed an AIIP-worthy driving-under-the-influence (DUI) offence that was not reported to the Dutch driving license authority. Persons in the control group were not sanctioned with an AIIP, but had their case settled in the criminal court. Our outcome measure was the percentage of offenders who committed at least one new DUI offence within the follow-up period. Results indicate that the percentage of repeat offenders in the AIIP group was lower than in the control group. Additional analyses indicate that were an AIIP to be imposed alongside a criminal settlement, a recidivism reduction of 4 percentage points (4 % versus 8 %) could be expected. This would translate to a relative decrease of 54 %. Explanations for these findings are discussed.

Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First-Time DUI Offense.

Driving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence-based therapy in these programs may help prevent DUI recidivism. We conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first-time DUI offense who screened positive for at-risk drinking in the past year. Participants were randomly assigned to a 12-session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10months later. We conducted intent-to-treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol-related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings. Participants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD=12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4- and 10-month follow-ups compared to participants receiving UC (odds ratio [OR]=0.37, p=0.032, and OR=0.29, p=0.065, respectively). This intervention effect was more pronounced for females at 10-month follow-up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4- and 10-month follow-ups. Participants in both UC and CBT reported significant within-group reductions in 2 of 5 outcomes, binge drinking and alcohol-related consequences, at 10-month follow-up (p<0.001). In the short-term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short-term reductions in impaired driving.

Study design to evaluate cognitive behavioral therapy among a diverse sample of adults with a first-time DUI offense.

BackgroundDriving under the influence (DUI) of alcohol is a major public health concern, and many individuals continue to drink and drive even after being convicted of a DUI offense. Latinos, in particular, are disproportionately likely to be arrested for a DUI, have higher rates of recidivism, and are more likely to die in alcohol-related accidents than non-Latino Whites. Latinos also experience significant disparities in accessing alcohol-related treatment.Methods/designThis study protocol paper describes a randomized trial of cognitive behavioral therapy (CBT) compared to usual care in DUI programs for individuals with a first-time offense and at-risk drinking. We will utilize a two-group randomized design where individuals enrolled in a DUI program with a first-time conviction will be randomized to CBT (n = 150) or usual care (n = 150). Participants will be assessed at baseline, immediately post-treatment, and 6-months post-treatment. Recidivism data will be collected using administrative data within 2 years post-treatment.DiscussionThis project has the potential to benefit a large population of vulnerable individuals who are at risk of DUI recidivism. It also develops a new model of care by providing treatment in DUI programs to reduce disparities associated with poor treatment access.Trial registration NCT02588703

A pilot study comparing in-person and web-based motivational interviewing among adults with a first-time DUI offense.

BackgroundDriving under the influence (DUI) is a significant problem, and there is a pressing need to develop interventions that reduce future risk.MethodsWe pilot-tested the acceptance and efficacy of web-motivational interviewing (MI) and in-person MI interventions among a diverse sample of individuals with a first-time DUI offense. Participants (N = 159) were 65 percent male, 40 percent Hispanic, and an average age of 30 (SD = 9.8). They were enrolled at one of three participating 3-month DUI programs in Los Angeles County and randomized to usual care (UC)-only (36-h program), in-person MI plus UC, or a web-based intervention using MI (web-MI) plus UC. Participants were assessed at intake and program completion. We examined intervention acceptance and preliminary efficacy of the interventions on alcohol consumption, DUI, and alcohol-related consequences.ResultsWeb-MI and in-person MI participants rated the quality of and satisfaction with their sessions significantly higher than participants in the UC-only condition. However, there were no significant group differences between the MI conditions and the UC-only condition in alcohol consumption, DUI, and alcohol-related consequences. Further, 67 percent of our sample met criteria for alcohol dependence, and the majority of participants in all three study conditions continued to report alcohol-related consequences at follow-up.ConclusionsParticipants receiving MI plus UC and UC-only had similar improvements, and a large proportion had symptoms of alcohol dependence. Receiving a DUI and having to deal with the numerous consequences related to this type of event may be significant enough to reduce short-term behaviors, but future research should explore whether more intensive interventions are needed to sustain long-term changes.

Recidivism Risk of Repeat Intoxicated Drivers Monitored with Alcohol Biomarkers

This feasibility study analyzed the effects of alcohol biomarker testing in reducing the rearrest rates and/or lengthening the time between rearrests in repeat intoxicated drivers in Waukesha County. Participants were 250 repeat offenders who underwent monitoring with biomarker testing after being arrested for driving under the influence (DUI) of alcohol between 2006 and 2009. In 2012, their traffic records were reviewed to determine any subsequent drunk driving arrests since their assessments in 2006 to 2009. Regression analysis was used to determine the relationship between the length of biomarker monitoring (LOM) and the time to recidivism (TTR). LOM was defined as the time between the offender's first test at enrollment in this study (baseline Early Detection of Alcohol Consumption [EDAC]) and the last test at the end of monitoring. TTR was defined as the length of time from baseline EDAC until the driver's next subsequent DUI offense. The results showed that 32 of the 250 drivers enrolled in this pilot were rearrested during the study period for an overall recidivism rate of 12.8%. The rearrested drivers were mostly men (88%), young adults (34 years), employed (84%), and predominantly single or divorced (86%). Their drinking profile at baseline showed that 93% claimed at least one month of abstinence before their first sample was collected yet almost one half (48%) of them tested positive for biomarkers. Regression analysis showed a positive and significant correlation between LOM and TTR (r = 0.41; p < 0.05; coefficient for LOM = 1.28; N = 23) indicating that for every additional day of biomarker monitoring the time to re-arrest increased by more than one day. This feasibility study provides preliminary evidence suggesting that repeat DUI offenders monitored with alcohol biomarkers take longer to get rearrested with a subsequent DUI than those not monitored with biomarkers.

Predicting DUI Decisions in Different Legal Environments: Investigating Deterrence With a Conjoint Experiment

Objective: Driving under the influence (DUI) enforcement practices and sanctions contribute differentially to the certainty, swiftness, and severity of punishment, which are the key components of general deterrence theory. This study used a conjoint experiment to understand the decision-making process of potential DUI offenders and tested how variation in enforcement and legal punishment affects drinking and driving decisions. It sought to verify and quantify the unique deterrent effects of certainty, severity, and swiftness and to predict the rates of drinking and driving in different legal environments. Methods: One hundred twenty-one college seniors and graduate students at the University of Maryland participated in the Web-based conjoint experiment. They were randomly assigned to 4 blocks, each of which included 9 hypothetical scenarios composed of different levels of DUI enforcement and penalties. Respondents were asked to state their likelihood of drinking and driving under each scenario, as well as their estimated chance of being caught by the police for DUI. Results: Intensified enforcement, harsh jail penalty, and immediate long license suspension were found to be the strongest deterrents to drinking and driving. Alternative ways to get home were also important in reducing people's willingness to drive. These factors accounted for most of the attribute effect on the DUI decision, whereas delayed punishment due to judicial processing, fine penalty, and legal blood alcohol concentration (BAC) limit had negligible effects. For the personal characteristics, college seniors and those who had previously driven after drinking were more likely to choose to drink and drive, whereas those who expect a jail penalty for a DUI offense were less likely to drive. Conclusions: Our research confirmed and quantified certainty of punishment as the greatest deterrent to DUI, but it also indicated the equally important effect of a severe jail penalty. It provides evidence on the feasibility of using a conjoint experiment in future studies to understand the general driver population and, with the help of a simulation tool, to predict DUI decisions in different legal environments. Such predictions can be used to better inform policy decisions on developing targeted general deterrence programs in different communities.

Deterring DUI Behavior in the First Place

Dugosh, Festinger, and Marlowe’s (2013, this issue) study is an important pilot study aimed at the development of a brief screening device that contains objective items to predict recidivism. We must continue to develop criteria that will help us distinguish between driving-under-the-influence (DUI) offenders who are at significant risk of repeating the offense in contrast to those offenders who learn their lesson from the first offense and never repeat the offense, no matter what sanction they experience. The identification of offenders with a high risk of repeating the offense will help prosecution and adjudication officials assign appropriate sanctions for the offense and implement appropriate monitoring of the offenders to prevent recidivism. Studies have shown that approximately one third of all offenders arrested for DUI are repeat offenders (Fell, 1995; Fell, Tippetts, and Voas, 2010) and that drivers with a DUI offense are at approximately four times the risk of being alcohol positive in a fatal crash (Fell, 1992). If we can accurately identify those firsttime DUI offenders at high risk of repeating, then countermeasures can be implemented to prevent the recidivism. This approach will improve public safety. Although identifying high-risk offenders is certainly important, it must be recognized that, as Dugosh et al. (2013) note, the criminal justice system continues to apply remedial programs based primarily on prior offenses and the blood-alcohol concentration (BAC) at the time of arrest. This process occurs despite the availability of screening tests with reasonable validity. The use of such assessment instruments was popularized 40 years ago by the National Highway Traffic Safety Administration’s (NHTSA’s) national Alcohol Safety Action Program (ASAP) implemented in 35 communities in the United States between 1969 and 1975. Currently, however, using these instruments has been restrained, not by the lack of useful test instruments but by the lack of court personnel resources to administer them (Voas and Fisher, 2001). As an example, it has been difficult to persuade adjudication

Alcohol Consumption Among Drivers Subject to the Swiss License Restriction of Zero Tolerance When Driving

Background: The restriction of zero tolerance when driving (ZTD) imposed on drivers in Switzerland means that they may drink no alcohol at all before driving and basically consume only moderate amounts of alcohol at any other time. The Institute of Traffic Medicine in Zurich has recently started to confirm this moderate alcohol consumption by analyzing hair samples for ethyl glucuronide (EtG), a metabolite of ethanol. On the basis of the EtG results, this article looks at the alcohol consumption of drivers subject to ZTD restrictions and determines what recommendations can be made in relation to traffic safety. In particular, the behavior of people with alcohol dependence, who are known to have a reduced ability to control their drinking, is looked at in detail. Methods: Data from all 250 persons with ZTD restrictions, assessed at our Institute in 2010, were evaluated retrospectively. These drivers included 220 men and 30 women, all aged between 21 and 75 (mean age 41 ± 12 years). At the time of the expert review, 26 (10.4%) had no record of driving under the influence (DUI), 121 (48.4%) had one DUI offense, and the rest had 2 or more drunk driving offenses. The length of time for which ZTD is imposed is determined on an individual basis, depending on the history of use and course of events. Results: EtG hair analysis of all 250 drivers with ZTD restrictions provided the following results: EtG assay was not performed in 16 cases (6%); 126 drivers (50%) did not have any detectable EtG (corresponding to total abstinence); 93 (37%) had an EtG concentration within the limits of social drinking; and the EtG concentration indicated excessive alcohol use by 15 people (6%). EtG was found to be in the range of excessive alcohol consumption in 3 (8%) of the drivers diagnosed as alcohol dependent. It was seen that the majority of those drivers who had previously abstained totally from alcohol continued to do so. None of the drivers with ZTD restrictions committed any drunk driving offenses in 2010. Conclusions: Imposing a ZTD restriction on individuals with moderate alcohol consumption or those with previous alcohol problems who have been stable for some time and now drink little or no alcohol is worthwhile. In addition, total abstinence from alcohol should be made a license restriction for those with serious alcohol dependence, due to the poor long-term prognosis.

Attitudes do matter: The role of attitudes and personality in DUI offenders

Several studies have related personality variables with antisocial behavior. Among antisocial behaviors, driving under the influence (DUI) has received growing attention in recent years, particularly in relation to the role of personality. However, it has been shown that personality alone is not sufficient to accurately predict DUI. As a result, there is growing interest in identifying other types of individual differences that might predict this behavior better, such as attitudinal variables. The aim of this study was to examine differences in personality dimensions and attitudes between a group of DUI offenders and a comparison group. Ninety-eight subjects were assessed: 51 subjects who had been convicted of a DUI offense following a diversion program, and 47 drivers without criminal records. Personality was measured with the NEO-Five Factor Inventory (NEO-FFI) and antisocial attitudes were assessed with the Jesness Inventory-Revised. Results indicated that offenders were more prone to show antisocial attitudes (p<.001) than comparisons. In terms of personality, there were no significant differences between the two groups. These findings suggest that attitudes may be useful predictors of DUI and should be taken into account in interventions designed to avoid recidivism.

Multicultural web-based motivational interviewing for clients with a first-time DUI offense.

Culturally and linguistically appropriate interventions are needed to reduce the risk of driving under the influence (DUI) recidivism among diverse populations. Using core elements of Motivational Interviewing, we developed a culturally relevant web-MI intervention (web-MI) in English and Spanish to serve as a standalone or adjunctive program in DUI educational settings and evaluated its feasibility and acceptability among clients with first-time DUI offenses. We conducted an iterative formative assessment using focus groups with staff (n = 8) and clients (n = 27), and usability interviews with clients (n = 21). Adapting MI for the web was widely accepted by staff and clients. Clients stated the web-MI was engaging, interactive and personal, and felt more comfortable than past classes and programs. Spanish-speaking clients felt less shame, embarrassment, and discomfort with the web-MI compared to other in-person groups. Results support the viability of web-MI for DUI clients at risk for recidivism and highlight the importance of adapting the intervention for diverse populations. Key decisions used to develop the web-MI are discussed.

Unraveling the complexity of driving while intoxicated: A study into the prevalence of psychiatric and substance abuse comorbidity

Objective Research is beginning to provide an indication of the co-occurring substance abuse and mental health needs for the driving under the influence (DUI) population. This study aimed to examine the extent of such psychiatric problems among a large sample size of DUI offenders entering treatment in Texas. Methods This is a study of 36,373 past year DUI clients and 308,714 non-past year DUI clients admitted to Texas treatment programs between 2005 and 2008. Data were obtained from the State's administrative dataset. Results Analysis indicated that non-past year DUI clients were more likely to present with more severe illicit substance use problems, while past year DUI clients were more likely to have a primary problem with alcohol. Nevertheless, a cannabis use problem was also found to be significantly associated with DUI recidivism in the last year. In regards to mental health status, a major finding was that depression was the most common psychiatric condition reported by DUI clients, including those with more than one DUI offence in the past year. This cohort also reported elevated levels of Bipolar Disorder compared to the general population, and such a diagnosis was also associated with an increased likelihood of not completing treatment. Additionally, female clients were more likely to be diagnosed with mental health problems than males, as well as more likely to be placed on medications at admission and more likely to have problems with methamphetamine, cocaine, and opiates. Conclusions DUI offenders are at an increased risk of experiencing comorbid psychiatric disorders, and thus, corresponding treatment programs need to cater for a range of mental health concerns that are likely to affect recidivism rates.

Substance Abuse Problem Severity Among Rural and Urban Female DUI Offenders

Objectives: Although there has been an overall decline in the rates of driving under the influence (DUI) over the past two decades, this decrease has not occurred uniformly across all groups of DUI offenders. For example, the proportion of female DUI offenders has significantly increased. Furthermore, DUI arrest rates remain higher in less populated areas of the country. The present study examines indicators of problem severity among female DUI offenders across graduated levels of rurality. Methods: A total of 19,094 substance abuse assessment records from females convicted of DUI between 2002 and 2006 in Kentucky were examined. Beale codes were used to define the extent to which the county of conviction was rural. Results: Rurality was significantly and positively associated with multiple DUI offenses, being underage, drug problems, prevalence of DSM-IV-TR substance dependence and abuse criteria, being referred to substance abuse treatment rather than an education only intervention, and referral noncompliance. Blood alcohol concentration and alcohol problems were inversely related to rurality. Conclusion: The study suggests that problem severity among female DUI offenders may be greater in rural areas and could produce challenges for practitioners who assess and treat rural female DUI offenders.

The Alcohol Interlock: An Underutilized Resource for Predicting and Controlling Drunk Drivers

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression (Marques et al., 2003) show that BAC elevations > .02-.04% are more potent predictors of repeat DUI ( p < .0001) than even prior DUI ( p < .006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec; .04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.

The Alcohol Interlock: An Underutilized Resource for Predicting and Controlling Drunk Drivers

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression (Marques et al., 2003) show that BAC elevations > .02–.04% are more potent predictors of repeat DUI (p < .0001) than even prior DUI (p < .006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec; .04% Alberta). Charts tracking the Monday–Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.