Are we near a limit or can we get more safety from vehicle alcohol interlocks?

Key aspects of successful rehabilitation after repeated or serious driving offenses

OBJECTIVE

In Germany, license restoration after serious or repeated offenses requires a positive medical psychological assessment (MPA), a test to determine the driver's aptitude. Fulfilling the conditions necessary for a positive MPA often takes longer than the period of license revocation, which is perhaps due to the involvement of different personal, organizational, and environmental factors. To optimize the rehabilitation process, the present study analyzed the key aspects of successful rehabilitation after repeated or serious driving offenses.

METHODS

After participating in the MPA, 1,631 subjects completed a questionnaire about rehabilitation efforts. The selection of items for this questionnaire was made according to our own prior research, interviews with problem drivers, and the diagnostic criteria for the MPA. Participants were asked when and from whom they obtained certain information and how relevant this information was for their success. In contrast to other studies, which used reoffense rates as a criterion for successful rehabilitation, we used a positive MPA result (positive, negative, or training) as the criterion for success.

RESULTS

Just over half (52%) of the participants considered themselves optimally informed about the rehabilitation process. The others (47.4% of participants) judged the adequacy of information received as less than satisfactory. Offenders who did not partake in counseling before the MPA achieved a successful result only about half as often (37.1%) as those who did (70%) and were around 3 times as likely to have additional courses imposed upon them (21 vs. 7.6%). Of the offenders who received crucial and helpful information at an early stage, 62.4% attained a positive MPA at the first attempt (regardless of having attended any training courses). The success rate for the first attempt rose to 81% for offenders who were well informed at an early stage and participated in counseling before their first MPA.

CONCLUSION

The results clearly indicate that the provision of relevant information at an early stage combined with counseling has a beneficial influence on success rates for the rehabilitation process (an increase from 37.1 to 81%). As such, we recommend the introduction of obligatory license consultations, offered by MPA experts, involving a status assessment to customize offenders' rehabilitation and thereby provide more or less intensive guidance or coaching depending on offenders' characteristics throughout their progression through the MPA system.

DUI offenders' experience with an ignition interlock program: comparing those who have and have not adapted from their primary drinking location

OBJECTIVE

The purpose of this study was to compare driving under the influence (DUI) offenders on an alcohol ignition interlock program who had or had not changed their primary drinking context from a bar/restaurant where they might be required to drive after drinking before the interlock was installed to drinking at home where driving would not be likely to be required following interlock installation.

METHODS

A total of 171 DUI offenders who were on an ignition interlock program completed a web-based survey. All of these offenders reported that they drank primarily in a bar/restaurant before the interlock was installed. These offenders were classified into 2 groups: adapters who said they currently drink at home and nonadapters who said they still drink in a bar/restaurant. Measures were made of their reported drinking, driving patterns, perceptions of the likely outcomes of being on the interlock, perceived effectiveness of various prevention strategies, and demographic characteristics. Chi-square and t-test analyses were used to compare these 2 groups.

RESULTS

Adapters and nonadapters did not differ with regard to any of the demographic characteristics, whether they were a first-time DUI offender, the length of time in the interlock program, number of lockouts (being blocked from starting their cars) they had experienced, miles driven per week, or current driving patterns since being on the interlock program. Adapters were more likely to report changing their drinking plans and habits. Currently they reported fewer drinks per occasion than nonadapters. They were more likely to report reducing the amount they drink, solo drinking or only drinking with a spouse/significant other, and changing their drinking plans and habits. They were also more likely to say that the interlock reminded them to limit their drinking after it is removed and that it might have longer term benefits in preventing future DUIs. They were also more receptive to interventions that might help them separate their drinking from their driving.

CONCLUSIONS

Interlock clients who report that they have altered their drinking context and a willingness to receive programs that help them separate their drinking from their driving may be more receptive to and benefit from ignition interlock programs.

How necessary is monitoring to interlock program success?

OBJECTIVE

Numerous studies have demonstrated that vehicle alcohol ignition interlocks installed on the cars of impaired-driving offenders reduce recidivism by approximately two-thirds in comparison to similar offenders whose licenses have been suspended. An unresolved issue is the extent to which the effectiveness of interlock programs can be improved by close monitoring of the offenders' performance while in the program. This article describes 5 types of monitoring currently being used in interlock programs in the United States.

METHODS

The programs reviewed vary from those that simply ensure that the interlock is on the offender's vehicle and functioning, to those that use the interlock log data to extend the length of time the offender is required to be in the interlock program, and those that use the interlock data to initiate special monitoring and treatment programs that must be completed before removal of the interlock device. The strengths and limitations of each type of program are described. Also reviewed are current technological developments that appear to be leading to the development of fully automated interlock monitoring systems.

RESULTS

Initial evidence shows that more intensive monitoring provides benefits in improved performance on the interlock, as indicated by fewer high blood alcohol concentration (BAC) breath tests when attempting to drive. Although effective, supervision that is more intensive increases government program costs.

CONCLUSIONS

The relative cost-effectiveness of the differing types of monitoring requires investigation. Treatment programs need to be integrated with the interlock installation period. New technologies can potentially reduce interlock offender monitoring costs and effectiveness. Integrating treatment with the interlock could have postinterlock benefits.