DUI Laws: California DUI Countermeasures

DUI Countermeasures in California: What works and what doesn't.

REPORT TO THE LEGISLATURE OF THE STATE OF CALIFORNIA

SEPTEMBER 2002

EXECUTIVE SUMMARY

Motor vehicle crashes are the leading cause of death for Americans aged 4 to 34. In the year 2000, a total of 41,821 people were killed in traffic crashes in America, and 16,653 (or about 40%) of those fatalities involved alcohol. After major reductions in driving-under-the-influence (DUI) achieved during the 1980's and early 1990's, progress against DUI has slowed and stalled, and the most recent (years 1999/2000) California data show the first increase in DUI fatalities since 1987. The prevailing view of DUI in America since the mid-1990's has been that all of the easy targets of opportunity had been identified and remediated, and that additional reductions in DUI would only be gained incrementally, and in small measure. The slowdown of progress against DUI in the late 1990's, along with the recent negative reversal in DUI trends, seemed to validate the perception that "all had been done that could be done." In light of this present review (conducted pursuant to Senate Bill 776, Torlakson, 2001) of scientific literature on effective DUI countermeasures, however, this prevailing perception can be seen as self defeating and unduly pessimistic. Based on the scientific evidence, there are at least four DUI legislative programs and initiatives that have the potential of producing major reductions in the incidence of DUI, as large or larger than the reductions seen in the 1980's. These countermeasures include:

1. Pharmaceutical Treatment for Convicted DUI Offenders
   Although drugs (particularly antabuse) have been used in the treatment of alcoholism for decades with minor success, there are new pharmaceutical treatments which are offering renewed hope for the efficacy of this approach. One promising new drug is naltrexone, which acts to reduce the opioid response to alcohol that causes alcoholics to continue drinking to excess. Since the mid-1980's, studies at the University of Pennsylvania and Yale University have established the effectiveness of naltrexone in reducing the craving and consumption of alcohol. A major study of naltrexone and acamprosate drug treatments, alone and in conjunction with psychosocial treatment, is currently being conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 11 university research centers across the United States. Based on the demonstrated success of naltrexone in these university studies, the time is right to pilot test and scientifically evaluate the impact of these new pharmaceutical treatments in the real world applied setting of the DUI countermeasure system. The DUI system provides an efficient means of identifying persons in need of treatment for alcohol abuse via arrests for DUI, and the system structure and service delivery components could be used to facilitate the trial of pharmaceutical treatment for convicted DUI offenders, either at the court, probation, or drinking driver treatment program level. As in clinical trials, the most definitive and scientifically rigorous research involves random assignment to treatment conditions; in this case, convicted DUI offenders would be randomly assigned to existing DUI sanctions and treatment, or to existing sanctions and treatment plus drug treatment. The purpose of random assignment is to avoid bias between groups which could compromise the evaluation of treatment effects, so that the only systematic difference between treatment conditions is the presence or absence of the additional drug treatment. Such a randomized study of pharmaceutical treatment could corroborate the university clinical trials and dramatically improve the effectiveness of treatment for DUI offenders. The development of this pilot program would involve the input of a wide variety of professionals from the medical and judicial fields, as well as the cooperation of state and local agencies involved in DUI control.
2. Alcoholic Beverage Control
   Research has clearly shown that alcoholic beverage control policies are associated with reduced consumption of alcohol and resultant reductions in the multiple negative consequences associated with that consumption, including alcohol-involved traffic crashes and fatalities. The federal Prohibition laws of the 1920's demonstrated the positive societal benefits of reduced availability of alcohol, yet ultimately proved untenable because of insufficient public support. The majority of American adults consume alcohol, and perceive positive benefits from this consumption, particularly in social settings. Yet the vast majority (86%) of Americans also support increasing taxes on alcohol in order to support drunk driving countermeasure programs. Additional economic policies that also impact the price of alcohol include price controls and limits on rebates, discounts, or other economic inducements. Other alcoholic beverage control measures include marketing control policies and regulations on the manufacture, distribution, advertising, and sale of alcohol.
3. Reduce crashes associated with on-premise drinking
   Research has shown that roughly half of all alcohol-related crashes involve drinking at an on-premise establishment, while only a quarter of all alcohol is consumed onpremise. These facts clearly identify on-premise drinking as a major target of opportunity for reducing drunk driving. Several DUI countermeasures address this problem, including designated driver programs, server intervention programs, alcoholic beverage control laws and server liability. Research has shown that server intervention programs can be effective in reducing the proportion of patrons who leave an establishment above illegal per se levels, and one study identified a reduction in alcohol crash measures associated with server intervention. California's Department of Alcoholic Beverage Control (ABC) has an active server intervention program which is offered free of charge to licensed establishments on request. The voluntary 4-hour program has trained over 150,000 servers since the program was initiated in 1995. Although the current program has been successful, mandatory server intervention training as part of the ongoing ABC licensing process might have wider impact. California has not had an effective server liability law ever since the dram shop law was repealed in 1978. The Centers for Disease Control (CDC) review of server intervention programs and liability laws recommended that server liability laws are likely more effective than server intervention programs. In California, the gap between the current virtually nonexistent server liability statutes and the repealed dram shop laws from 1978 is sufficiently large to provide a wide "middle ground" for server liability statutes which responsibly address the overrepresentation of on-premise drinking among alcohol related crashes, while responding to the concerns of the industry (including insurance costs).
4. Increase DUI prevention and general deterrence efforts, particularly those targeting youth
   If an ounce of prevention is worth a pound of cure," and there is evidence that this concept applies to alcohol abuse and impaired driving, then a shift in priorities from punishment to prevention might be in order for our overall societal response to alcohol-impaired driving. Recent research evidence that the age of onset of drinking is a primary predictor of adult alcohol abuse points to the need to target prevention efforts at youth. Research also suggests that prevention efforts and public information and education (PI&E) campaigns would benefit from a professional marketing approach similar to that used by commercial interests to promote alcohol consumption. One key to any successful PI&E campaign is to have a viable concept to "sell," one which will make sense to and be embraced by the target population. One such campaign in the area of DUI prevention is the designated driver program, which has survived the initial media blitz and become entrenched in the public consciousness as one practical method of avoiding alcohol-impaired driving. One of the more effective prevention efforts, which is often not seen as such, is sobriety checkpoints. The ultimate function of a sobriety checkpoint is not to catch drunk drivers (although DUI offenders are apprehended and arrested), but as a general deterrent to the larger public of potential impaired drivers, discouraging or "preventing" them from driving impaired in the first place.

WHAT WORKS?

Based on a review of the existing scientific literature, the following countermeasures have proven significantly effective in reducing alcohol-impaired driving:

• Effective Driver-Based Countermeasures
• Minimum drinking age laws
• Per se BAC laws
• Administrative per se license action laws
• "Zero-tolerance" laws for youth
• Other licensing actions, including restriction and probation
• Alcohol treatment
• Server intervention programs
• House arrest in lieu of jail
• Lower per se BAC for repeat offenders
• Sobriety checkpoints
• Public information and education
• Effective Vehicle-Based Countermeasures
• Vehicle impoundment or immobilization
• Ignition interlock
• Other Countermeasures Impacting Alcohol-Impaired Driving
• Seat belts
• Graduated driver licensing
• Alcoholic beverage control

WHAT DOESN'T WORK?

The following countermeasures, which have long formed the basis of punishment for convicted DUI offenders, have not proven effective in reducing impaired driving:

• Jail or community service
• Fines

WHAT MIGHT WORK?

The following countermeasures may prove effective in reducing alcohol-impaired driving:

• Preliminary Breath Test (PBT) BAC testing of all crash-involved drivers
• Designated driver and safe rides programs

Alternative treatment modalities, including pharmaceutical treatment Most of the scientifically proven effective countermeasures listed above have been implemented, if not initiated, in California. It is important that the integrity of these countermeasures is maintained, and that new DUI legislation and programs do not diminish or work at cross-purposes to laws and programs that are effective, including the minimum drinking age law, "illegal per se" BAC level, administrative per se license actions, "zero-tolerance" for youthful offenders, postconviction license suspension and revocation, and drinking driver program treatment. Caution should be used in expanding underutilized DUI programs with promise, including server intervention programs, house arrest in lieu of jail, sobriety checkpoints, PI&E campaigns, vehicle impoundment and interlock, in order that these programs can be maximally effective and target the appropriate population of offenders. At the same time, California should focus on and fully explore those legislative and program areas that provide the greatest opportunity for having the largest impact in reducing the incidence of alcohol-impaired driving. This involves a fundamental shift in focus from punishment to prevention.

RECOMMENDATIONS FOR CONSIDERATION

In addition to the four major initiatives identified earlier, based on the review of scientific evidence regarding existing DUI countermeasures, the following DUI legislation and programs also provide opportunities for reducing the incidence of DUI:

• Lower illegal per se BAC levels for target groups
• Mandatory license suspension for all convicted DUI offenders
• Mandatory vehicle impoundment for persons arrested for a repeat DUI offense
• Increased use of house arrest in lieu of jail.

In addition, the following initiative offers the potential to improve the identification and prosecution of DUI offenders:

• Permissive hospital BAC testing

CONCLUSION

California has long been recognized as a leader in traffic safety, and many of the demonstrably effective DUI countermeasures have already been enacted and implemented in this state, including the minimum drinking age law, the 0.08% "illegal per se" BAC level, administrative per se license action, "zero tolerance" for youthful offenders, drinking driver treatment programs, ignition interlock, and vehicle impoundment. While California has enacted most of the known effective DUI countermeasures, there are countermeasures implemented in other states which might be of benefit to California, such as a lower per se BAC level for repeat offenders. There are also effective countermeasures which are not implemented as widely as they might be, including house arrest in lieu of jail, sobriety checkpoints, and server intervention programs. Most importantly, there are four major initiatives which offer the potential for large-scale reductions in alcohol-impaired driving, including new pharmaceutical treatments (naltrexone), increased alcoholic beverage control, reducing the contribution of on-premise drinking to the DUI problem, as well as prevention efforts focused on youth. There continues to be strong public support for anti-DUI efforts, including the raising of alcohol taxes, provided the funds are used against drunk driving.

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Tags: California DUI |  DUI Prevention