Blow and go: the Breath-Analyzed Ignition Interlock Device as a technological response to DWI

Driving while intoxicated rates have declined substantially in the last 20 years. This is as a result of public opinion combined with increased law enforcement efforts. A recent tool has been the Breath Analyzed Ignition Interlock Device. This new technology is designed to prevent persons with excessive blood alcohol levels from operating the interlocked vehicle. This 3-year recidivism study of the ignition interlock revealed 17.5% recidivism rates for the interlock group compared to 25.3% recidivism rates for the non-interlock group, a 31% decrease. Multiple offenders and younger (under 30) offenders had significantly lower rates of subsequent arrests. The multi-offenders in the comparison group were more than twice as likely as the interlock group to have a subsequent conviction within 3 years. The difference was nearly the same for the under 30 age group. There was almost no difference for first offenders. Accordingly, the ignition interlock appears to significantly reduce recidivism for repeat and younger DWI offenders but offers almost no improvement for first offenders. One driver of 315 (0.32%) was charged with DWI with an interlock in place. This offender had a child provide the breath sample while she drove the vehicle.     

The Alberta Interlock Program: the evaluation of a province-wide program on DUI recidivism

Aims. This study was designed to determine the efficacy of alcohol safety interlocks in reducing recidivism among first and second driving-under-the-influence (DUI) offenders. It also evaluates the overall effectiveness of interlock programs where typically only a small portion of DUI offenders elect to install interlocks. Design. The driving records of DUI offenders participating in interlock programs for 6 months for first offenders and 2 years for second offenders were compared with similar offenders who chose not to participate. Setting. A province-wide program in Alberta, Canada. Participants. Records of 35 132 drivers convicted of DUI between 1 July 1998 and 30 September 1996 were analyzed. Measurements. Repeat DUI offenses during and after the interlock period. Findings. While the offenders had interlocks on their vehicles, DUI recidivism was substantially reduced. Once the interlock had been removed and the participants had been reinstated, their DUI rate was the same as other offenders indicating that the interlock reduced recidivism while in place. Because only 8.9% of eligible drivers elected to participate in the interlock program, the program did not significantly increase the overall effectiveness of the province's management of DUI offenders. Conclusions. Interlocks are associated with a major reduction in DUI recidivism while on the vehicle of the offender. However, because few offenders elect to participate, the program produces only a small (5.9%) overall reduction in the recidivism rate of all DUI offenders.     

Reducing Driving Under the Influence Recidivism in Massachusetts

This article compares the effects of treatment and jail sentences on DUI recidivism among offenders. The effectiveness of an ignition interlock system in reducing recidivism is also considered.     

Requiring suspended drunk drivers to install alcohol interlocks to reinstate their licenses: effective?

Aims To evaluate a new method being used by some states for motivating interlock installation by requiring it as a prerequisite to reinstatement of the driver's license. Design The driving records of Florida DWI offenders convicted between July 2002 and June 2008 were analyzed to determine the proportion of offenders subject to the interlock requirement who installed interlocks. Setting Most driving‐while‐impaired (DWI) offenders succeed in avoiding state laws requiring the installation of a vehicle alcohol interlock. Participants A total of 82 318 Florida DWI offenders. Findings Due to long periods of complete suspension when no driving was permitted and the failure to complete all the requirements imposed by the court, only 21 377 of the 82 318 offenders studied qualified for reinstatement, but 93% of those who qualified did install interlocks to be reinstated. Conclusions Because of the lengthy license suspensions and other barriers that the offenders face in qualifying for reinstatement, it is not clear that requiring a period on the interlock as a prerequisite to reinstating will greatly increase the current installment rate.     

Victim Impact Panels: Who Is Sentenced To Attend? Does Attendance Affect Recidivism of First‐Time DWI Offenders?

BACKGROUND: Victim Impact Panels (VIPs) have been implemented widely in the United States by judges as a deterrent to drinking and driving, but there is little evidence of their utility in preventing recidivism. OBJECTIVES: The objectives of this study were to examine judges' referral patterns to the VIPs among a multiethnic population of convicted first-time driving while impaired (DWI) offenders and to compare 5-year recidivism rates of those mandated and not mandated to attend the VIP. METHODS: Study participants included 5,238 convicted first-time DWI offenders who were referred to a screening program in Bernalillo County, New Mexico, and who completed a personal interview with a master's-level counselor between April 1989 and October 1995. Logistic regression analysis was used to evaluate judges' preferences in mandating offenders to attend a VIP. The percent of subjects reoffending in the 5 years following their referral for screening was calculated by standard life-table analyses. Cox proportional hazards analysis was used to test the effects of known independent predictors for recidivism. Separate models were developed for the entire population, non-Hispanic offenders, and Hispanic/Mexican national subgroups. RESULTS: Female judges who regularly adjudicated DWI offenders were more likely to refer offenders to a VIP. Judges were less likely to refer men and offenders with less than 12 years of education and an unknown arrest blood alcohol concentration (BAC), and of Hispanic/Mexican national or other race/ ethnicity. Judges were more likely to refer unmarried offenders to a VIP. After controlling for multiple risk factors, referral to VIP was not a strong predictor of recidivism in Hispanic and non-Hispanic ethnic groups, with 95% confidence limits ranging from 0.8 to 1.0, compared to those not referred. CONCLUSIONS: Female judges were more likely than male judges to refer offenders to a VIP, and referral patterns varied by offender characteristics. The VIP referral did not increase rearrest rates but lowered them marginally to not at all. This study should be followed up with a randomized design to control for referral patterns and to further define the impact of mandating offenders to the VIP.     

Concurrent and predictive validity of drug use and psychiatric diagnosis among first-time DWI offenders

BACKGROUND: Previous studies have found that driving while intoxicated (DWI) offenders report high rates of substance dependence and other psychiatric disorders. METHOD: The current study evaluated the prevalence, clinical correlates at program admission, and prognostic significance over a 1-year follow-up of 2 diagnostic subgroup variables (drug abuse or dependence; mood or anxiety disorder) among 290 first-time DWI offenders receiving group counseling interventions. RESULTS: A lifetime diagnosis of drug abuse or dependence (42% of sample) was associated with higher levels of alcohol consumption, lower coping confidence, greater readiness to change, increased alcohol, drug, and legal problems, and more alcohol-related negative consequences at the initiation of DWI intervention. Significant decreases in drinking were noted at intervention termination for the drug diagnoses subgroup, but were not sustained at 1-year follow-up. The presence of a lifetime diagnosis of anxiety or mood disorder (30% of sample) was associated with lower coping confidence, greater readiness to change, and with greater and more enduring negative consequences of drinking during the DWI intervention and 1-year follow-up period. CONCLUSIONS: Results suggest that a psychiatric diagnosis might guide the intervention and aftercare planning for DWI offenders to reduce recidivism and drinking.     

DWI/DWAI offenders and recidivism by gender in the eighties: a changing trend?

The study is based on a systematic random sample from the New York State's Driver License File, which contains 15,032 drivers who were convicted of DWI/DWAI at least once in the period of 1978 to 1988. The analysis reveals (1) the proportion of male offenders 20 and younger continued to decrease through the 1980s, while the proportion of female offenders 21 and older increased; and (2) the female DWI/DWAI recidivism rate began to parallel the male recidivism rate after the mid-1980s. A number of factors may be attributed to the changing DWI/DWAI structure, such as the impact of the 21 alcohol purchase age law, the change of women's roles and lifestyles, and the changing attitudes of the public and the police toward female drinking-driving.     

A Swedish alcohol ignition interlock programme for drink-drivers: effects on hospital care utilization and sick leave

AIMS: This project evaluates health outcomes following an alcohol ignition interlock programme (AIIP) by assessing hospital care utilization and sick-leave register data relative to controls with revoked licences, but with no comparable opportunity to participate in an AIIP. SETTING: In Sweden, driving while impaired (DWI) offenders can now select voluntarily a 2-year AIIP in lieu of 12 months' licence revocation. The AIIP includes regular medical check-ups designed to alter alcohol use. DESIGN: The study is a quasi-experimental intent-to-treat design; accordingly, the intervention group includes 48% of the participants who were dismissed from the AIIP before completion. FINDING: The control group (865 individuals) showed increased hospital care and sick leave after licence revocation following the DWI. Among the 1266 people in the AIIP, however, significantly fewer needed hospital care relative to controls, and relative to their own care utilization before the DWI offence. This occurred whether care reflected all diagnosis or only alcohol-related diagnosis. Also, sick-leave data showed significantly fewer AIIP group individuals using sick leave relative to the control group, and relative to their own pre-treatment period. These significant health benefits disappear in the post-treatment period. However, among those who actually do complete the entire AIIP, sustained positive health effects are observed 3 and 4 years after the DWI offence. CONCLUSIONS: Voluntary participation in an AIIP has favourable effects with less need for hospital care or sick leave. This is probably linked to reduced alcohol consumption during the programme and to the ability to continue driving.     

DUI recidivism by intervention adherence: a multiple risk factor approach

ABSTRACT

Background: Multi-component impaired driving interventions can reduce driving under the influence (DUI) recidivism rates; however, outcomes are better for those who complete the interventions and are adherent with program expectations. Research is needed to examine the differences between DUI offenders who are adherent vs. non-adherent to intervention efforts. Objective: The current study utilized a multi-risk factor model to predict recidivism among first-time DUI offenders enrolled in an intervention program. Differences between offenders who were adherent (including program completion) vs. non-adherent with the intervention were examined. Method: Using data from the Mississippi Alcohol Safety Education Program (MASEP) and state administrative records, the current study examined both recidivism rates and rates of intervention completion for all individuals enrolled in the program. The sample was predominantly White (58.8%) and male (80.2%). Results: Individuals who were adherent with the intervention were significantly less likely to recidivate within 3 years. Prior traffic or other criminal violations positively predicted recidivism rates. The likelihood of recidivism varied, with males, African Americans, and younger individuals with less education at greater risk of recidivism. Adherence with the intervention was more common for African American and older participants. Conclusion: The MASEP participants who were adherent with the intervention were significantly less likely to recidivate than those who were non-adherent. However, variance in the multi-component intervention completion rates suggests that the program resonates better with specific population subsets. We argue for researchers and policymakers to further explore how specific population subsets react to varying intervention programs to maximize efforts to reduce impaired driving.     

Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offenders

AIMS: To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. SETTING: As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants are liable for all costs themselves. DESIGN: Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. FINDING: Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over 1000 euros (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. CONCLUSIONS: The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes.     

Interactions Among DUI Offender Characteristics and Traditional Intervention Modalities: a long-term recidivism follow-up

Using long-term DUI (Driving Under the Influence of Alcohol) arrest recidivism data from a controlled study of DUI intervention effectiveness, interactions among DUI interventions, age, race, education, and alcohol severity were estimated using logit analysis. Data were collected in a 9-year follow-up study of the Mississippi DUI Probation Project. The effects of short-term interventions (alcohol education schools for low alcohol severity offenders and structured group interventions for high alcohol severity offenders) were specified by educational level. Short-term rehabilitation was modestly effective for those with less than 12 years of education, but less effective or detrimental for the more highly educated. The effects of probation were specified by age and education, being more effective for those under 30 years and 55 years or older than for the middle aged group. Probation was most effective for well-educated older (55 +) offenders. An analysis of the under 30 years group also suggested that probation was especially effective for young well-educated Minority offenders.     

Towards a national model for managing impaired driving offenders

Aims To describe a proposed national model for controlling the risk presented by offenders convicted of driving while impaired (DWI) and promoting behavioral change to reduce future recidivism. Setting Traditional methods of controlling the risk they present to the driving public are not adequate, as indicated by the fact that approximately 1000 people are killed each year‐in alcohol‐related crashes involving drivers convicted of DWI in the previous three years. However, stimulated by the success of special drug courts for substance abusers and new technological methods for monitoring drug and alcohol use, new criminal justice programs for managing impaired driving offenders are emerging. Intervention A national model for a comprehensive system applicable to both drug and alcohol impaired drivers is proposed. The program focuses on monitoring offender drinking or the offender driving employing vehicle interlocks with swift, sure but moderate penalties for non‐compliance in which the ultimate sanction is based on offender performance in meeting monitoring requirements. Findings Several new court programs, such as the 24/7 Sobriety Project in South Dakota and North Dakota and the Hawaii's Opportunity Probation with Enforcement (HOPE) Project, which feature alcohol/drug consumption monitoring, have produced evidence that indicates even dependent drinkers can conform to abstinence monitoring requirements and avoid the short‐term jail consequence for failure. Conclusions Based on the apparent success of emerging court monitoring systems, it appears that the cost of incarcerating driving‐while‐impaired offenders can be minimized by employing low‐cost community correction programs paid for by the offender.     

Do Risk Factors for Re‐Arrest Differ for Female and Male Drunk‐Driving Offenders?

BACKGROUND: The present study investigated gender differences in factors affecting recidivism among 628 female and 659 male drunk-driving offenders. The study population included residents from New Mexico who completed a screening program for offenders and who were still residents when contacted 5 years later. METHOD: Risk factors for re-arrest in the 5-year period after screening referral were examined using multiple logistic regression models. Predictor variables included gender, age, ethnicity, education, marital status, blood alcohol concentration at arrest, parental alcohol problems, spousal alcohol problems, lifetime use of cannabis, cocaine, or amphetamines, abusive behavior toward spouse, and scores on two standardized assessments. RESULTS: Risk factors for re-arrest were similar for males and females except that young age predicted higher recidivism among males but not females. The overall 5-year re-arrest rate was 26%-20% for women, 38% for males age 30 and under, and 24% for males age 31 and older. CONCLUSIONS: Young age predicts re-arrest for males but not for females. Neither the type of risk factors nor the number of risk factors fully explained female offenders' disproportionately lower recidivism rates, compared with young males.     

Randomized sanctions to reduce re-offense among repeat impaired-driving offenders

AIMS: This study, conducted within a driving under the influence (DUI) court intervention, evaluated the degree to which removing electronic monitoring (EM) and/or mandatory vehicle sales requirements increased rates of post-sentence traffic violations among repeat DUI offenders. DESIGN: Randomized trial. SETTING AND PARTICIPANTS: A total of 477 repeat DUI offenders entering the Driving under the Influence of Intoxicants (DUII) Intensive Supervision Program (DISP), Multnomah County, Oregon. INTERVENTION: Subjects were randomized into four intervention groups. Group 1: standard DISP with EM and vehicle sales requirements; group 2: standard DISP with mandatory vehicle sale, but without EM; group 3: standard DISP with EM, but without mandatory vehicle sale; and group 4: standard DISP without EM or mandated vehicle sale. Standard DISP includes treatment for alcohol abuse and dependence, polygraph testing, regular court appearances, and probation or court-based monitoring. MEASUREMENTS: The risk of re-arrest for traffic violations was compared among the four groups using hazard ratio estimates from complementary log-log regression models. FINDINGS: Compared with group 1, subjects in group 2 initially had increased re-arrest risks, but this effect dissipated within 3 years of entering DISP. Group 3 subjects had a 96% increase in re-arrest rates. Group 4 subjects had smaller increased risks than predicted, with re-arrest rates similar to those of group 1 at the end of the follow-up period. CONCLUSIONS: Although some of the findings suggest that mandatory vehicle sales may deter future traffic violations, inconsistent results across groups make this finding equivocal. Positive effects of EM, while large in the short term, appear to have a relatively small long-term value in reducing traffic arrest rates.     

Long-term Effectiveness of Probation, Short-term Intervention and LAI Administration for Reducing DUI Recidivism

Driving under the influence of alcohol (DUI) arrest records were checked for subjects participating in the Mississippi DUI Probation Follow-up project 6 to 9 years after project entry. The efficacy of short-term intervention, probation, and Life Activities Inventory (LAI) administration for reducing long-term DUI recidivism were evaluated using a logit analysis. A small but statistically significant effect of probation for reducing long-term recidivism was found for offenders classified both as low-risk and high-risk drinkers. However, an interaction effect of combining probation with short-term intervention, which was suggested by an earlier 2-year recidivism analysis, was not statistically significant after the longer tracking period. Administration of the LAI questionnaire was found to reduce recidivism only for offenders classified as low-risk, replicating findings after 2 years of recidivism tracking.     

False-positive breath-alcohol test after a ketogenic diet

A 59-year-old man undergoing weight loss with very low calorie diets (VLCD) attempted to drive a car, which was fitted with an alcohol ignition interlock device, but the vehicle failed to start. Because the man was a teetotaller, he was surprised and upset by this result. VLCD treatment leads to ketonemia with high concentrations of acetone, acetoacetate and beta-hydroxybutyrate in the blood. The interlock device determines alcohol (ethanol) in breath by electrochemical oxidation, but acetone does not undergo oxidation with this detector. However, under certain circumstances acetone is reduced in the body to isopropanol by hepatic alcohol dehydrogenase (ADH). The ignition interlock device responds to other alcohols (e.g. methanol, n-propanol and isopropanol), which therefore explains the false-positive result. This 'side effect' of ketogenic diets needs further discussion by authorities when people engaged in safety-sensitive work (e.g. bus drivers and airline pilots) submit to random breath-alcohol tests.     

Perception of Risk for Subsequent Drinking and Driving Related Offenses and Locus of Control among First-Time DUI Offenders

It is estimated that approximately one third of first-time driving-under-the-influence (DUI) offenders are at risk for committing a subsequent offense. To reduce the risk of recidivism, most states require mandatory screening and counseling of convicted DUI offenders. Unfortunately, the majority of offenders are not receptive to either screening or recommendations for further interventions designed to reduce their level of risk. The current study examines the relationship between locus of control and receptivity to risk status. To test this hypothesis, both the Rotter Internal-External Locus of Control Scale (I-E) and the Drinking Related Internal-External Locus of Control Scale (DRIE) were administered to a group of convicted first DUI offenders. The results indicate that the offenders manifesting a more internal locus of control were more receptive to risk information compared to their external locus of control counterparts. Important clinical implications of these findings are discussed.     

Predicting Termination from Drug Court and Comparing Recidivism Patterns: Treating Substance Use Disorders in Criminal Justice Settings

Drug courts have been used in the criminal justice system to treat substance use disorders since 1989. This study evaluates a drug court in Indiana, focusing specifically on the most predictive variables for being terminated from the program and comparing recidivism patterns of drug court and probation participants. Participants were most likely to be terminated from drug court if they did not have a high school diploma or equivalent at admission, were not employed or a student at admission, identified cocaine as a drug of choice, had more positive drug tests, had a violation within the first 30 days of the program, and had a criminal history. Additional findings suggest that drug court is more effective than probation at reducing criminal recidivism rates for offenders with substance use disorders. Implications for drug court practice and future research are discussed.     

Failure to reduce drinking and driving in France: a 6-year prospective study in the GAZEL cohort

Aim   An unprecedented decline in alcohol consumption and road mortality has been observed recently in France, but it is still unclear whether or not these changes affected driving while alcohol-intoxicated (DWI). The objective of the study was to estimate prospectively trends of excessive speed on the roads, alcohol consumption and DWI between 2001 and 2007 in a large cohort of experienced drivers.
Methods   Participants were current employees or recent retirees of the French national electricity and gas company, who volunteered to participate in a research cohort established in 1989 under strict conditions of anonymity. An annual cohort questionnaire is sent to participants that includes two questions about overall alcohol consumption. In 2001 and 2007, 10 684 participants reported their driving behaviours using the same self-administered questionnaire.
Results   Between 2001 and 2007, the proportion of participants ( n  = 10 684) who reported having driven at speeds at least 20 km/hour above the limit decreased from 23.7% to 4.1% in built-up areas ( P  < 0.001), from 34.3% to 9.3% on rural roads ( P  < 0.001) and from 24.3% to 2.7% on highways ( P  < 0.001). Regular and non-regular excessive alcohol consumption decreased from 22.7% to 19.7% and from 18.0% to 14.9%, respectively, whereas DWI increased from 22.9% to 25.3% over the same period ( P  < 0.001).
Conclusions   A recent crackdown on road violations by the French government has failed to deter DWI. Given that DWI seems to be a sporadic and rarely punished behaviour, its prevention requires more coercive measures, such as using a breath alcohol ignition interlock device.