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.”