Paul Marques - Drive Sober or Get Pulled Over
Transcrição
Paul Marques - Drive Sober or Get Pulled Over
Interlock Programs 22 Years Later: Penetration, Effectiveness, DUI Control, First Offender Impact, DUI Prediction, Supplemental Technologies, Barriers, Standards, Guidelines Illinois Interlock Meeting October 29, 2008 Paul Marques ([email protected]) Senior Research Scientist, PIRE Chair, ICADTS Interlock Working Group Four Basic Elements (of interlock devices) (1) an alcohol sensor that prevents engine starts if breath alcohol is detected above some minimal level such as BAC ≥ .02 g/dL (e.g., .02%) (2) a running retest feature, which requires at least one retest after the car has started, typically retests are every 15 to 45 minutes while driving (3) a tamper-detecting installation in the engine, which requires inspection every 30 to 60 days to preclude bypass wiring (4) a data-recording system that logs the time of all BAC tests, starts, stops, procedural violations or circumvention attempts. Where did interlocks get started? • In the 60s after NASA and the Peace Corps, Bob Voas was a young man in his early 40s who came to take a lead at a new federal agency – the Office of Safety Programs – it later became NHTSA. Bob the NASA guy merged with Bob, the safety guy. He asked… • Why can’t we use space age technology to help solve social problems? • In 1969 he wrote a paper titled: Cars that Drunks Can’t Drive. • Bob worked with Borg Warner Corp. which made the first prototype interlock. • The first interlocks were performance devices (e.g., reaction time etc.) • 20 years later in 1989 (when I was in my early 40s), we began collaboration on the US Interlock Model Specifications. Devices and Programs Not the same • In 1992 the US DOT through NHTSA published a set of recommended guidelines for states’ Certification of the Devices (The Model Specifications…) • In 2008, still no federal guidelines to provide recommendations to states for writing laws or managing interlock Programs. This info is mostly coming from MADD and from interlock providers. • Not all the best practice issues are settled but we have gathered much evidence over the years. Draft practice guidelines could be written. Interlocks in service by year 250000 200000 O 150000 100000 50000 09 20 07 20 05 20 03 20 01 20 99 19 97 19 95 19 93 19 91 19 87 89 19 -50000 19 Ye ar 0 Events in interlock history 250000 200000 California law NHTSA Model Specs 150000 100000 -N --- M ---s w la O ICADTS IWG 50000 MADD Campaign Voas AB study Beck MD study 09 20 07 20 05 20 03 20 01 20 99 19 97 19 95 19 93 19 91 19 87 89 19 -50000 19 Ye ar 0 What’s next? Can it be done? If so how to do it? First and multiple offenders, More enforcement, Better monitoring, Program tied to the BAC tests and other objective indicators, Stronger (less appealing) alternatives for the opt outs… 1400000 1200000 1000000 800000 600000 400000 ■ MADD projection ■ 200000 0 19 86 19 90 19 94 19 98 20 02 20 06 20 10 20 14 FBI estimate of 1.4 million DUI arrests annually. MADD Campaign to End Drunk Driving will seek 600,000 more interlocks in 5-7 years. 1,4 million DUI arrests annually (in 2007: FBI) Some Things That We Know… • Interlocks reduce recidivism for both first and multiple offenders, but only while installed. • The interlock provides its own punishment. At least initially, it is not a good idea to further punish lockouts. • The record of breath tests can be used to predict future (post-interlock) recidivism. • When interlock programs are discretionary, enrollment is rarely more than 25%, usually much less. • More controlling (unpleasant) alternatives to interlock improve participation in interlock programs. • The easiest circumvention is driving a car with no interlock – so driver licenses need “INTERLOCK” clearly marked so police who stop a driver know the violation. Some Things That We Need… • National (non-binding) guidelines to advise states on a sensible core of best interlock program practices • Courts to understand that interlocks were NOT designed to be abstinence monitoring tools • Higher penetration to help determine if interlock programs reduce alcohol crashes • Better probation/monitoring resources to assure compliance • Use of supplemental objective indicators such as alcohol biomarkers to assess driver risk • Link treatment services (when warranted) to the interlock program and objective indicators • To try to end the cycle of capture and release Things That We Do Not Know… • Whether the highest risk DUI offenders will accept the interlock – even if it means no license if they do not. • Whether mandatory programs force people out of compliance with the license control system (e.g., would they drive without license and insurance?). • What the best way is to carry-over reduced drinking driving beyond the interlock controlled period. • What are the best criteria for extending someone for additional interlock time – we need evaluation evidence (what should trigger extension? for how long?) • Whether hard suspension time (before interlock) brings any safety benefit. • If we can make do with one type of interlock program. Recidivism Reduction Compared to Non-Interlock Group (set to 100%) 140% Contrast groups for each study set to 100% 120% 100% 80% 60% 40% 20% 0% 1 OH 2 OR 3 NC 4 AB 5 WV 6 MD During Interlock 7 AB 8 QC 9 IL 10 NM Striped Bars are After Interlock Removal Same People as Solid Bars Non-interlock contrast groups for each study - black line 140% 120% 100% 80% 60% 40% 20% 0% 1 OH 2 OR 3 NC 4 AB 5 WV During Interlock 6 MD 7 AB After Interlock 8 QC 9 IL 10 NM What about First Offenders? 70 • Alcohol Mentions/1000 drivers in Maryland – 5 million licensees • The distinction between first and second offender is small compared to first and nonoffender. • A first offender has ten times more alcohol mentions than a non-offender. • A second offender has only 25% more than a first time offender. 60 50 10x higher 40 30 20 10 0 0 1 2 3 Prior DUI Rauch et al., TRB 2002 Similar evidence from New Mexico Percent Re-Arrested for DWI Within Three Years vs Priors For Those Convicted of DWI in NM in 2003 % Re-arrested within 3 Years 25% 5x higher 20% 15% 10% 5% 0% None 1st 2nd 3rd 4th 5th+ Conviction Number in 2003 Relative to Non-Offenders, First Time DUI Offenders are 5x more likely to be arrested within 3 years for DUI NM first offenders’ re-arrest for groups with and without interlock (one year) Fraction Rearrested for DWI .07 .06 .05 Comparison Group .04 .03 .02 Interlock Group .01 Roth, Voas & Marques, 2007 Traffic Injury Prev. .00 0.00 0.25 0.50 Years 0.75 1.00 T1S28 (Comparison Group shifted 28 days from conviction) Alberta “Survival” (non-recidivism) First Offenders 1 yr during and 2 yr after Interlock Voas, Marques, Tippetts, Beirness (1999) Interlock: median 6-8 BAC tests every day* Quebec BAC Tests per day 1100 * 7x 365 = 2555 tests/year 1000 900 800 700 600 500 Frequency 400 300 200 Std. Dev = 4.63 Mean = 8.8 100 N = 9176.00 0 .0 32 .0 30 0 . 28 .0 26 0 . 24 .0 22 0 . 20 .0 18 .0 16 0 . 14 .0 12 0 . 10 0 8. 0 6. 0 4. 0 2. 0 0. How can we use this BAC test data to profile DUI offenders? • Imagine that we divided 7200 DUI offenders using the interlock and ranked them from those with the lowest rate of positive BAC tests to the highest rate. BAC tests • Rate = positive all BAC tests • If you divided them into ten groups so each group had about an equal number… • …and then you reinstated all the driving licenses and waited two years – what would the repeat offense rate look like? 24 Mo. AFTER INTERLOCK Predicting Future DUI with the RATE of high Interlock BAC tests N=720 Offenders in Each Bar Data from Marques, Voas, Tippetts (2003) Addiction, Quebec Prediction Study Support from NIAAA DURING INTERLOCK BAC Rate ≥ .02% 7,200 DUI offenders: 18.8 million BAC tests % ivism 5 2 id c re Recidivism for ten decile groups based on rate of tests with BAC≥ .02% and by postinterlock time out to 24 months 24 hs t on m Profiling the High Risk Driver • There are a variety of ways that hazardous drinkers identify themselves. • We know the rate of positive BAC tests is an important predictor of future DUI risk… • But so too is the timing pattern of positive BAC tests. • People with more elevated morning BAC tests (due to prior night of drinking) have more recidivism events too. 7-8 am Weekdays - Max positive BAC Confirmed in 4 jurisdictions (TX,AB, QC, NM) – based on more than 40 million BAC tests 1.00 0.80 0.60 0.40 Quebec All Tests Quebec Tests>=.02% Alberta All Tests Alberta Tests >=.02 Texas All Tests TX tests>.02% 0.20 0.00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Hour of Day Similar results from New Mexico max number positive BAC tests 7-8 am Monday to Friday BAC test record is a good, but incomplete indicator. Why? • The interlock is a vehicle sanction - Anyone may drive the car and contribute BAC tests • Someone who parks the car and waits out the interlock may show no risk evidence • But – there are biological sources of risk evidence that have a wider surveillance window than BAC • Alcohol biomarkers – many types with differing detection windows (urine, blood, hair) Biomarker Interlock results 2008 508 DUI offenders in Alberta lid a V 0 1 isM l ta o T . 1 2 t o T yste S .0 .1 4 9 0 1 6 3 8 6 2 4 0 1 8 0 5 2 3 0 4 5 .2 5 .6 9 4 .3 9 1 0 1 2 .8 6 .8 2 5 .5 0 2 2 .8 6 .5 9 7 .0 m 5 .9 26.8% Failed Tests are BAC ≥ .04 g/dL None 52.8% 20.5% Supported by NIAAA R01 – AA - 014206 High Few Rates of FAILED Interlock BAC Tests by Alcohol Biomarker Levels PEth* in whole blood GGT* in blood serum none few high few high few high FAEE in hair EtG* in urine none none few high none Ten alcohol biomarkers (in standard scores) by failed interlock tests 0 = mean of all This top 20% needs special attention if they do not change during interlock Can we be sure that the highest risk offenders are in some program? • No! • We know of no comprehensive monitoring done anywhere in North America (e.g., biomarkers, interlock BAC record) except a few research programs • With a few exceptions, there is still very little criterionbased interlock sentencing • There is no natural linkage being made between interlock program performance and treatment requirements – currently it is mostly backwards (treatment is imposed before interlocks) • Interlocks provide a wealth of data – they should be serving a key screening function – but this is rarely done. • Monitoring and treatment would serve better as supplemental supportive interventions not preconditions Cumulative percent positive BAC 100.0% Cumulative Percent 80.0% 60.0% 40.0% 20.0% 0.0% 0 2 4 6 8 10 12 14 16 18 20 22 24 27 29 31 33 total BAC > .02 over 6mo 10 38 41 43 52 57 76 87 112 Rate of elevated BAC tests over time Alberta Data, ’94-’99, replicated in Texas ‘03 LEARNING TO COMPLY? BAC tests rates ≥ .02% over time at 2 month intervals by prior offenses Alberta 2008 First Offenders Multiple Offenders Interlock Extensions? • Several states are now using an adjustable requirements. Violations for BAC or procedural faults result in longer interlock period – – – – CO: 1 yr extension for 3 positive tests, WV: demerits awarded for positives can lead to extensions, MI: 3 positive BACs adds 3 months, VA: requires 6 months of no elevated BACs, if not, clock resets. • Recommendation: People need to first learn about why BAC is still high the morning after a binge, then once they learn they should be expected to adjust behavior. If they don’t they should be extended. • OR…controlled Less Appealing Alternative to Interlock? • If abstinence is the goal, transdermal monitoring is more suited to it. • 24/7 wear for approx. 3-6 mo.~ $12/day. • Alternative: House arrest (electronic monitoring) has been shown to increase enrollment in NM, IN. Is there still a good argument for long hard suspension after conviction? • • 1. 2. 3. 4. I don’t know. But, I don’t think so. Hard suspension was a hard won achievement of the safety community (before interlocks). But now consider… Interlocks are not a reward for good behavior, they are a shield to protect the public. They help offenders learn to associate a BAC test result with recent drinking. 50-75% of suspended offenders drive anyway. Suspended offenders without interlocks have 3 to 4 times higher DUI repeat convictions than those with interlocks (data follows). The problem with hard suspension following a conviction: Multiple DUI Offenders in 6 states 13% data from Voas and Tippetts 12% of Suspended Multiple Offenders Repeat DUI in the first 6 months 12% During suspension 10% After reinstated 8% 6% 4% 2% o m 72 o m 66 m o 60 o m 54 48 m o o m 42 36 m o o m 30 m o o 24 m 18 m o 12 6 m o 0% Need for Reporting Guidelines • Language matters! • Many interlock providers issue “Violation Reports” to the monitoring authority. • The providers should not be making judgments (e.g., violations) – just issuing reports with facts. Value neutral wording is better (e.g., “events”). • Companies are not constrained to any common standard of even what constitutes a breath test, much less circumventions, or other violations. • It is not simple to compare data across companies, so it is time for government to tell providers what is expected and needed to do business in its state. • To do that, governments need to know what they need. Some of barriers/challenges today • • • • • • • • • • • • • Low penetration (~10%) Inconsistent assignment of interlocks to offenders Inconsistent report formats across providers Inadequate follow through (in some places) Court education and engagement (so many courts) Underfunded probation departments almost everywhere Public education/ general deterrence promotion Few well thought through extension programs Little motivational use of less appealing alternatives Long hard suspensions still prevalent Little use of the interlock BAC test records Little linkage to treatment (or motivational) intervention Not enough evidence to select best program features The problem of using current interlocks to enforce “abstinence” “The fear expressed by some is that the abstinence requirement, were it to become widely imposed on DUI offenders, could transform a pragmatic, self-funded, drunk-driving preventative intervention into a tool for BAC monitoring. An abstinence requirement would render each of those lockouts due to high BAC as a “violation” of the court order and, therefore, subject to further sanctioning. However, road safety related to alcohol does not require abstinence; it just requires there be no drinking and driving. This difference reflects [different] frames of reference between the interests of the criminal justice system and public safety system. The frame differences are very similar to the ones that divide the medical care system and the public health system. In the former instances, it is the individual that receives the focus of attention, and in the latter instances, it is community safety and health that receives the focus of attention. Both are important so we need to find a middle way.”