Texas Impaired Driving Task Force

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Provided by Avertest: Reducing DUI by Predicting & Monitoring Alcohol & Substance Use

Reducing DUI by Predicting & Monitoring Alcohol & Substance Use

Part 2: Predicting DUI Recidivism with a Proactive Approach

Provided by Avertest

As discussed in the first article of this series, even though DUI related fatalities have declined, the number of DUI arrests have remained relatively flat over the past 20 years – resulting in over 121 million substance-impaired driving episodes in the past year alone. What’s more alarming, is a small percentage of drivers (3-5%) account for 80% of the DUI episodes experienced.1 The Traffic Injury Research Foundation tells us that a distinct group of individuals account for the bulk of drunken driving episodes, arrests, and fatalities. Repeat DUI offenders continue to commit the same offense time and time again, leaving the underlying problem of substance use untreated; over 30% of all DUI offenders have previously been convicted of a DUI and/or license revocation.2 The good news is, though it can be challenging, substance use is treatable; under policy changes and a concentrated effort to address and treat the deeper issue of substance use, we can continue to decrease DUI episodes and make dramatic improvements in millions of lives.

If it goes untreated, chances are that substance use will repeatedly occur. 94% of repeat DUI offenders were previously arrested for a drug or alcohol related offense.3 Chronic substance users repeatedly continue to drive under the influence after being convicted of that very offense; an estimated 50 to 75% of convicted offenders continue to drive drunk.4 In the U.S. alone, there are two million 3-time DUI offenders and 400,000 5-time DUI offenders.5Drivers with a BAC of 0.08% or higher involved in fatal crashes were 7x times more likely to have had a prior conviction for DUI than drivers with no alcohol in their system.6 All of the statistics above reinforce one statement: repeat offenders can be identified and their behaviors can be predicted. The 3-5% of people that account for 80% of impaired driving episodes tend to have glaring track records; almost half of repeat DUI offenders have a diagnosable substance use disorder and often a co-occurring psychiatric disorder.7,8

So how do we begin to identify or predict repeat offenders? Efforts to predict risk should be guided by research and evidence-based practices. Policies and practices developed from risk assessment research can help to further reduce the extent of future drunk driving. For example, low-risk client outcomes fair better via low-risk interventions and high-risk client outcomes fair better via high-risk interventions.9 Unfortunately, repeat DUI offenders often initially rank as low risk because they have steady employment and housing  so it is more effective to consider factors such as high BAC levels and multiple traffic infractions when determining whether they will pose a threat and be harmful in the future.10  If more effective measures like these are used to identify these individuals the first time drivers under the influence are convicted, it is much more likely repeated offenses could be prevented.   

Policy makers, justice officials, and health care providers are in a prime position right now to assist in the reduction of driving under the influence and will continue to play an important role in impacting driving under the influence episodes. Immediate improvements that can be made to reduce impaired driving include:

  • Drug Recognition Expert
  • Road Side Oral Fluid Devices
  • Alcohol assessment/screening
  • Measurement-based Systematic Monitoring
  • Substance Use Disorder Treatment
  • DUI Courts – the best of which reduce recidivism rate by 50% to 60%

It’s understood that predicting risk will not eliminate drunk driving completely, but it will likely help reduce it. Substance use takes time to heal; imagine what could be possible if we address the root cause versus the symptom and take the time to treat it. The results it could have on communities across the country would be extremely impactful. During the ongoing process of treatment, monitoring substance use plays a vital role in the success of achieving sobriety. In the next article of this series, we will cover alcohol and drug monitoring techniques and the best ways to monitor substance use. If you have any questions on how to effectively monitor alcohol and drug use in your program, please contact us at [email protected].

 

References

  1. Jewett A, Shults RA, Banerjee T, Bergen G Alcohol-impaired driving among adults— United States, 2012. MMWR Morbi Mortal Wkly Rep. 2015;64(30):814-17.
  2. FARS 2014 ARF
  3. APPA, A coffee can, factor analysis, and prediction of antisocial behavior: the structure of criminal risk, Kroner, Mills, and Reddon (2005)
  4. Fell, Jim. “Repeat DWI Offenders in the United States.”
  5. MADD, 2008 DUI Felony Overview
  6. FARS 2005 Final File and 2014 ARF
  7. Lapham, S.C., C’de Baca, J., McMillan, G.P., & Lapidus, J. (2006a). Psychiatric disorders in a sample of repeat impaired-driving offenders. Journal of Studies on Alcohol, 67(5), 707–713.
  8. Shaffer, H.J., Nelson, S.E., LaPlante, D.A., LaBrie, R.A., Albanese, M., & Caro, G. (2007). The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment-sentencing option. Journal of Consulting and Clinical Psychology, 75(5), 795–804.
  9. Carey, S.M., Van Wormer, J., & Mackin, J.R. (2014). Maintaining fidelity to the juvenile drug court model: Let’s not throw the baby out with the bath water. Drug Court Review, 9(1), 74–98.
  10. Marlow, D.B., Hardin C.D., Fox, C.L., (2016). Painting the Current Picture, A National Report on Drug Courts and Other Problem-Solving Courts in the United States. National Drug Court Institute, 19.