DUI Laws: California DUI Countermeasures

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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