Mandated Substance Abuse Treatment for Ignition Interlock Users. Does it Reduce Recidivism?

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National Center for Injury Prevention and Control Mandated Substance Abuse Treatment for Ignition Interlock Users Does it Reduce Recidivism? Title Lifesavers 2016 Effective Implementation of Ignition Interlock Programs April 3, 2016 Ruth Shults National Center for Injury Prevention and Control, CDC rshults@cdc.gov

Yes, it looks promising!

Why CDC??

WHY CDC?

http://www.thecommunityguide.org/mvoi/aid/ignitioninterlocks.html

Ignition Interlocks Reduce Alcohol-Impaired Driving "We know that interlock devices can save lives. More widespread use of ignition interlocks will reduce alcohol-related crash deaths and injuries. February 22, 2011 CDC Director Dr. Thomas R. Frieden

Community Guide Ignition Interlock Review Findings Re-arrests declined by a median of 67% while interlocks installed Interlocks appeared to be equally effective for first offenders as for repeat offenders Upon removal, re-arrest rates are similar to rates of offenders who did not install an interlock http://www.thecommunityguide.org/mvoi/aid/ignitioninterlocks.html Elder RW, et al. American Journal of Preventive Medicine 2011:40(3);362-76.

Community Guide To Increase Effectiveness Consider integrating interlocks into DUI courts or other comprehensive rehabilitation programs Consider intensive monitoring of offenders & performance-based criteria for removal of interlock

Florida Project Question Does mandated substance abuse treatment for DUI offenders on interlocks, based on their interlock breath tests, reduce post-interlock recidivism? Background Number of lockouts on interlock is predictive of recidivism postinterlock 1 In 2008 Florida initiated a treatment program tied to offender behavior on the interlock Provide monitoring, treatment, and education to offenders with multiple DUI offenses on the interlock 1 Marques 2003. Behavioral measures of drinking: Patterns in the interlock record. Addiction 2003:98;13-19.

Florida Project Cooperative Agreement between CDC s Injury Center and the Pacific Institute for Research and Evaluation (PIRE) Florida Dept. of Highway Safety and Motor Vehicles Milton Grosz PIRE scientists CDC Bob Voas Scott Tippets Eileen Taylor Paul Marques Ted Miller Gwen Bergen

Florida Ignition Interlock Requirements DUI Conviction Ignition Interlock Requirement First Conviction First Conviction if 0.15 or above or minor in car Second Conviction Second Conviction if 0.15 or above or minor in car Third Conviction Four or More Convictions (Condition of Hardship License) If court ordered At least 6 months At least 1 year At least 2 years At least 2 years At least 5 years https://www.flhsmv.gov/ddl/iid.html; Source: Section 316.193, Florida Statutes

Florida Administrative Interlock Program Treatment Policy Violation #1 Offender goes for an educational review of interlock operations and preventive measures Violation #2 Offender goes into monthly case management monitoring program including regular review of interlock logs Violation #3 Offender continues in monthly monitoring program AND goes into mandatory treatment program * Violation is two lockouts within 4 hours (trying to start with a BAC >.05)

Treatment Program Substance abuse counselors are licensed by Florida s Department of Children and Family Provider assesses problem and develops treatment plan Individual or group therapy Typically lasts 8-12 weeks Offender must complete treatment to have interlock removed http://www.myflfamilies.com/service-programs/substance-abuse/samh/treatment

Study Methods Data Florida Department of Motor Vehicles and Highway Safety administrative database of interlock program records Interlock records from the two Florida interlock vendors Alcohol Countermeasure Systems & LifeSafer Study Groups Treatment: 640 offenders with 3+ violations* who completed substance abuse treatment on interlock and deinstalled Comparison: 806 offenders similar to treatment group but had 1 or 2 violations and completed interlock period and deinstalled Analysis Survival analysis using Cox regression proportional hazards model to examine post-interlock recidivism * Violation is two lockouts within 4 hours (trying to start with a BAC >.05)

Characteristics of the Treatment and Comparison Groups of Multiple Offenders Treatment Comparison Value % % Age <25 3 4 25-34 21 21 35-44 27 29 45-54 32 30 55+ 9 10 Sex Male 78 82 Female 22 18 Race/Ethnicity White 76 75 Black 9 8 Hispanic 6 9 Other/Unknown 9 8 3+ Prior DUI Offenses N/A 45 58

Benefits of Substance Abuse Treatment for Multiple-offender DUI Ignition Interlock Users Overall: 32% lower recidivism among the treatment group after interlock removal over 30 months Prevented an estimated 45 rearrests 14 crashes 10 injuries Economic benefit Treated 640 DUI offenders at a cost of $192,000 ($300 each) Prevented $905,000 in crash costs Net benefit = $713,000

Conclusions Incorporating treatment into the ignition interlock program shows promise in reducing recidivism Referral to treatment based on performance on the interlock Offender must complete treatment to get interlock removed Increasing the number treated Currently 2.3% of offenders are treated (3+ violations) Study identified a group with similar risk of recidivism but <3 violations Some suggested criteria o 6 lockouts o 4 morning lockouts o Any test with a BAC 0.15%

Thank You For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

CDC Resources

Report at: www.cdc.gov/motorvehiclesafety/impaired_driving/ignition_interlock_states.html