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.     

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.     

Using Behavioral Triage in Court-Supervised Treatment of DUI Offenders

In 2008, San Joaquin County, California, implemented a system change where all repeat Driving Under the Influence (DUI) offenders in the largest judicial district (mainly the City of Stockton) are required to participate in a DUI Monitoring Court program. The program follows a behavioral triage system where offenders are placed into one of two tracks. Track 1 (monitoring) is a less intensive system where participants are required to come to court infrequently to report on progress in completing the terms of their probation, including Department of Motor Vehicle (DMV) requirements, to qualify to get their license returned. Track 2 is for participants who demonstrate through their behavior (i.e., behavioral triage) that they are unable to comply with Track 1 requirements and who are assessed as needing drug and alcohol treatment. Track 2 follows a drug court model. All repeat DUI offenders convicted after 2008 (i.e., program participants) and a comparison group of all repeat DUI offenders convicted in the 2 years prior to program implementation were tracked for 18 months from the time of their DUI conviction. DMV data were used to examine new DUI convictions and traffic accidents for both groups. The results showed that program participants had significantly fewer new DUI convictions, accidents related to drug and alcohol consumption, and accidents resulting in injury. Participants were also significantly more likely to comply with court, probation, and DMV requirements, and to regain their driver's licenses. The model implemented by the San Joaquin DUI Monitoring Court showed substantial promise for increasing public safety by reducing drunk driving and traffic accidents.     

Decreased re-conviction rates of DUI offenders with intensive supervision and home confinement

Background: In some jurisdictions, persons who are convicted of driving under the influence of alcohol (DUI) are allowed to serve some portion of their prison sentence under home confinement as part of Intensive Supervision Programs (ISPs) which include pre-release psycho-education and close post-release supervision. Objectives: Test the hypothesis that persons convicted of DUI offenses who have spent some portion of their sentence under home confinement, as compared to a historical comparison group, will exhibit a relatively low re-conviction rate. Methods: Using administrative data for 1,410 repeat DUI offenders (302 members of the historical comparison group, 948 ISP members, and 160 persons who appear in both groups at different points in time), with a follow-up period of up to 3 years and 10 months, a marginal Cox model was employed to compare conviction rates of persons who experienced intensive supervision and home confinement with historical comparison group members. Results: Persons with ISP + home confinement experience a re-conviction rate that is less than half that observed in the comparison group. Age, ethnicity (white vs. non-white), and gender are also significant predictors of re-conviction. Conclusion: Home confinement, in conjunction with psycho-education and other program elements, is one means of reducing the costs of incarceration. The results of this study suggest that, in addition to cost savings, states may realize a public safety benefit in the form of a reduction in DUI offense rates.     

Risk of alcohol abuse in urban versus rural DUI offenders

Background: Research concerning driving under the influence (DUI) offenses in rural populations is scarce and has often been carried out in the context of substance abuse and illicit drug use. Although previous studies have suggested that rural individuals are more likely to abstain from alcohol use, recent trends suggest that alcohol and substance abuse problems in rural areas are occurring at rates similar to urban areas. It is possible that urban and rural DUI offenders may differ on psychological and behavioral characteristics associated with heavy alcohol consumption. Objective: The aim of this study was to examine alcohol use differences between urban and rural DUI offenders. Methods: Data from 11?066 DUI offenders in a Midwestern state were used for this study. The Alcohol subscale of the Driver Risk Inventory II was used to assess the risk of problem alcohol use. Results: Higher levels of alcohol risk were associated with rural DUI offenders after adjusting for several demographic variables and blood-alcohol content level at time of arrest [Medium Risk OR?=?1.43, 95% CI: (1.20, 1.71); Problem Risk OR?=?1.43, 95% CI: (1.19, 1.72); Severe Risk OR?=?1.38, 95% CI: (1.14, 1.67)]. Conclusions: The results of this study indicate that rural DUI offenders have a significantly greater risk of heavy alcohol use when compared to urban DUI offenders. Practical implications of these results suggest that evaluators and assessors should be aware of an increased likelihood of alcohol problems in rural DUI individuals relative to those in urban areas.     

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.     

Decision-making in people who relapsed to driving under the influence of alcohol

Background: Alcohol use has been previously associated with neurocognitive impairments, especially in decision‐making cognition. However, some studies have shown little to no decision‐making deficits in relation to different characteristics of people with drinking problems. Relapsing to driving under the influence (DUI) of alcohol is an important issue with legal and psychosocial aspects. We evaluated decision‐making performance in second‐time DUI offenders by using the Iowa Gambling Task (IGT). Method: Thirty‐four male second‐time DUI offenders who had been selected for an official psychoeducational rehabilitation program and 31 healthy controls that were matched for age, education, and alcohol use were included. Along with psychiatric assessment, we applied conventional neuropsychological testing comprising cognitive set‐shifting, response inhibition, attention, and visuospatial abilities. Also, we used the Temperament and Character Inventory (TCI) to assess personality patterns. A computerized version of IGT was used. Results: No significant differences were found between the groups in regard to sociodemographics and conventional neuropsychological testing. DUI participants had significantly higher scores only in “self‐transcendence” subdomain of TCI. On the fifth block of the IGT, DUI participants had significantly lower net scores than controls (U = 380.0, p < 0.05). Also, DUI participants chose significantly more risky decks compared to controls. Conclusions: Our results suggest that there may be subtle decision‐making deficits in DUI participants, which goes undetected on conventional neuropsychological testing and which is not correlated with TCI subdomains related with impulsivity patterns.     

Effectiveness of interventions for convicted DUI offenders in reducing recidivism: a systematic review of the peer-reviewed scientific literature

Background: Driving under the influence (DUI) is a major cause of death and disability. Although a broad array of programs designed to curb DUI incidents are currently offered to both first-time and recidivist DUI offenders, existing evaluations of the effectiveness of these programs have reported mixed results. Objective: To synthesize the results of DUI program evaluations and determine the strength of the available evidence for reducing recidivism for different types of programs. Methods: A systematic review of all EBSCO databases, EMBASE, PubMed, ProQuest, Sociological Abstracts and TRIS was conducted to identify evaluations of treatments/interventions to prevent DUI offenses. Additional articles were identified from reference lists of relevant articles. Results: A total of 42 relevant studies were identified by the search strategy. Of these, 33 utilized non-experimental evaluation designs or reported insufficient data to allow effect sizes to be calculated, making meta-analysis unfeasible. Evaluations of several different program types reported evidence of some level of effectiveness. Conclusion: Because of the general lack of high quality evidence assessing the effectiveness of DUI prevention programs, it is not possible to make conclusive statements about the types of programs that are likely to be most effective. Nonetheless, there was some evidence to support the effectiveness of programs that utilize intensive supervision and education. There is a need for future evaluations to adopt more scientifically rigorous research designs to establish the effects of these programs.     

Twelve-month employment intervention outcomes for drug-involved offenders

Background: Employment has been identified as an important part of substance abuse treatment and is a predictor of treatment retention, treatment completion, and decreased relapse. Although employment interventions have been designed for substance abusers, few interventions have focused specifically on drug-involved offenders. Objectives: The purpose of this study was to examine employment outcomes for drug-involved offenders who received a tailored employment intervention. Methods: In a randomized controlled trial, baseline and follow-up data were collected from 500 drug-involved offenders who were enrolled in a drug court program. Participants were randomly assigned to drug court as usual (control group) or to the employment intervention in addition to drug court. Results: Intent-to-treat analyses found that the tailored intervention was associated only with more days of paid employment at follow-up (210.1 vs. 199.9 days). When focusing on those with greater employment assistance needs, a work trajectory analyses, which took into account participants’ pre-baseline employment pattern (negative or positive), revealed that intervention group participants had higher rates of employment (82.1% vs. 64.1%), more days paid for employment (188.9 vs. 157.0 days), and more employment income ($8623 vs. $6888) at follow-up than control group participants. Conclusion: The present study adds to the growing substance abuse and employment literature. It demonstrates the efficacy of an innovative employment intervention tailored for drug-involved offenders by showing positive changes in 12-month employment outcomes, most strongly for those who have not had recent employment success.     

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.     

An evaluation of the effectiveness of alcohol treatment, driver license actions and jail terms in reducing drunk driving recidivism in California

Abstract Aim. There has been long-standing interest in determining which sanctions work best to reduce drunk driving. This study examines the effectiveness of alcohol treatment, driver license actions and jail terms in reducing drunk-driving recidivism. Design. This quasi-experimental study examines the relationships between the sanctions that drivers convicted of driving-under-the-influence (DUI) receive and their subsequent reconviction of DUI, while statistically controlling for pre-existing differences among groups receiving different sanctions. Separate analyses were conducted for subjects having 0, 1 or 2 or more prior DUI convictions on their driving record. Setting. The study analyzes drunk driving reacidivism throughout the state of California. Participants. All drivers holding a California driver license who were convicted of DUI by a California court during 1990 and 1991 were selected for inclusion in the study. Measurements. A number of demographic, prior personal driving history and surrogate traffic environment measures were collected and used as covariates in the analyses. Data were also gathered on subsequent DUI reconvictions, and the number of days to first subsequent DUI reconviction, and used as outcome variables in the study. Findings. Results of the analyses showed that for all levels of prior DUI convictions, combining alcohol treatment with either driver license restriction or suspension is associated with the lowest DUI recidivism rates. Conclusions. Based on this research, and the results of prior studies, it can be persuasively argued that combining license actions with alcohol treatment represents the most effective sanction combination for combating DUI recidivism.     

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.     

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.     

A Randomized Trial of Oral Naltrexone for Treating Opioid‐Dependent Offenders

Offenders with a history of opioid dependence are a particularly difficult group to treat. A large proportion of offenders typically relapse shortly after release from prison, commit drug‐related crimes, and then are arrested and eventually re‐incarcerated. Previous research demonstrated that oral naltrexone was effective in reducing opioid use and preventing recidivism among offenders under federal supervision. The 111 opioid‐dependent offenders in this study were under various levels of supervision that included county and federal probation/parole, a treatment court, an alternative disposition program, and an intermediate punishment program. Subjects were randomly assigned to receive 6 months of either 300 mg per week of oral naltrexone plus standard psychosocial treatment as usual (n = 56) or standard psychosocial treatment as usual (TAU) without naltrexone (n = 55). While the TAU subjects who remained in treatment used more opioids than the naltrexone subjects who remained, the high dropout rate for both groups made it difficult to assess the effectiveness of naltrexone. The study provides limited support for the use of oral naltrexone for offenders who are not closely monitored by the criminal justice system. (Am J Addict 2010;00:1–11)     

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.     

Functioning of alcohol use disorder criteria among men and women with arrests for driving under the influence of alcohol

Background: Many states require screening of individuals arrested for driving under the influence (DUI) of alcohol to determine recidivism risk and the need for treatment based on severity of alcohol problems. Several screening instruments use DSM‐IV criteria for alcohol abuse and dependence to assess alcohol problems in this population, but whether they adequately measure alcohol problems in individuals with DUIs has not been examined. In addition, gender differences in DUI samples suggest that female offenders have more severe alcohol problems than male offenders. The current study examines differences in alcohol criteria functioning by DUI history and gender using an item response theory (IRT) approach. Methods: Data from diagnostic interviews with 8,605 participants in the Collaborative Study on the Genetics of Alcoholism, including 1,655 who ever reported a DUI arrest (20% women), were used to examine differences in alcohol criteria functioning between men and women with and without DUIs. The factor underlying item response was conceptualized as unidimensional, representing alcohol problem severity. Results: Social/interpersonal problems, larger/longer, and inability/persistent desire to quit displayed greater discrimination of IRT‐defined alcohol problem severity among individuals with DUIs than those without. Irrespective of DUI status, women had a higher threshold than men for time spent drinking or recovering. Women without DUIs had a higher threshold than similar men for social/interpersonal problems. Taken as a whole, the criteria yielded similar amounts of information in all groups. Conclusions: DSM‐IV criteria for alcohol abuse and dependence adequately detect alcohol problem severity in individuals with DUIs, and some are better at detecting severity in this particularly high‐risk group than in individuals without DUIs. However, the criteria as a whole are equally effective in measuring alcohol problem severity among individuals with and without DUIs and may be used with confidence in screening DUI offenders.     

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.     

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.     

Social status of DUI offenders in jail.

It has been argued that DUI (driving under the influence) is an offense of the economically privileged, which suggests that DUI offenders may be different from other offenders. Studies of DUI arrestees and jail inmates, however, suggest they have more extensive criminal histories than other licensed drivers and similar criminal histories to other jail inmates. This study utilizes data from a representative national survey of over 5,000 jail inmates to compare jailed DUI offenders with other offenders on social characteristics, prior criminality, drug use, and alcohol use. The purpose of these comparisons is to determine whether DUI inmates represent a distinct "class" of offender for whom jail is a new experience. The implications of this distinction for policies which mandate jail time for DUI offenders are discussed.