Another approach on drunken driving

24/7 Sobriety program better at changing long-term behavior

A TOUGH BUT fairly low-tech approach to drunken driving prevention is showing some promise in a handful of states and starting to pick up converts across the country.

Called 24/7 Sobriety and pioneered in South Dakota, the program typically requires individuals convicted of a second or subsequent drunken driving offense to visit a testing facility twice a day—once in the morning and again in the evening—and blow into a Breathalyzer. If any alcohol is detected, the person is immediately thrown in jail for a short time.

Studies from fields as diverse as psychology and economics say the threat of a swift, certain, and modest sanction is effective at preventing participants from driving drunk, and also may be effective at changing their behavior so that once they leave the program they stay sober.

Ignition interlock devices are the most prevalent policy response to drunken driving, with 30 states, including Massachusetts, using them. The devices are typically attached to the vehicle dashboard and drivers are required to blow into them before starting their car. If the device registers a blood alcohol concentration greater than a preset amount, the device prevents the engine from starting.

Keith Humphries, a professor of psychiatry at Stanford University, says the chief difference between the two approaches is the swiftness of punishment. Violators in the 24/7 program are sent to jail immediately after a failed test. By contrast, the ignition interlock device prevents a participant from driving a car but any punishment comes later, if at all.

“Most individuals worry much more about what will likely happen to them right now rather than what might await them down the road,” says Humphreys. “That’s why the 24/7 Sobriety program works much better than ignition interlocks.”

Humphreys says the twice-a-day checks are also effective at changing long-term behavior. “I believe the 24/7 program is more likely to lead to long-term behavioral changes in people, while simply getting them to stop drinking while they drive won’t,”  he says.

The 24/7 programs are currently being used in South Dakota, North Dakota, and Montana, and a pilot is up and running in Jacksonville, Florida. The approach got a big lift in December when President Obama signed legislation making 24/7 Sobriety eligible for the same federal grants that had previously been available just to ignition interlock programs.

“This new provision is really going to pave the way for other states to take a hard look at the program and see if they can fit it into to their toolbox of solutions to drunk driving,” says Col. Tom Butler of the Montana Highway Patrol.

Under Melanie’s Law, passed in 2005, Massachusetts drivers after their second drunken driving conviction are required to pay for the installation of an ignition interlock. If the person is driving with a hardship license, he or she must use the ignition interlock for as long as the license is in effect; for those whose licenses have been reinstated, ignition interlocks must be used for two years. Legislation has been filed to require the devices after just one conviction.

“That’s something we believe will greatly cut down on drunk driving here in Massachusetts,” says Mary Kate DePamphilis, the program manager for the Massachusetts chapter of Mothers Against Drunk Driving.

Ruth Shults, a senior epidemiologist at the Centers for Disease Control and Prevention in Atlanta, says extending the ignition interlock program to first-time offenders is a good idea because research shows they are just as likely to reoffend as those with more convictions. But she says research on ignition interlock devices indicates they have a serious shortcoming.

“What we found was that, on average, when the interlock is on the car, drunk driving re-arrests are reduced by about two-thirds,” she says. “But the problem is when the interlock comes off, the re-arrest rates climb right back up to where they are for people who don’t have interlocks.”

Butler, of the Montana Highway Patrol, says he began looking into South Dakota’s 24/7 Sobriety program after failing to see the positive results he was hoping for with ignition interlocks and after two of his officers were killed by drunk drivers in head-on collisions. Butler says the data from South Dakota convinced state leaders to offer 24/7 as one of several options available to judges for dealing with repeat drunk drivers.

“We took the view in Montana that we wanted to find something that had documented, peer-reviewed study results that showed a positive impact on reducing drug-driving recidivism,” he says.

How the actual testing is handled in Montana varies from county to county, according to Butler. In some counties, the test is administered by the sheriff’s office and in others by a private contractor. Individuals who fail the test are jailed immediately if the test takes place at a detention facility. At private facilities, law enforcement officials are summoned to take the person to jail. Jail time generally runs from 12 hours to two days.

Butler says the 24/7 program, like any drunken driving prevention program, does have its limitations. “This program isn’t for everybody,” he says. “While it has shown great success for a significant portion of the offenders, there are some for whom it will not work. They need more intensive help.”

Studies done by the Rand Corporation in Montana and South Dakota indicate their 24/7 programs have had a positive impact in reducing drunken driving. A study of the North Dakota program by the Upper Great Plains Transportation Institute at North Dakota State University also showed positive outcomes, particularly for women.

A cost comparison between the 24/7 and ignition interlock programs is difficult. The 24/7 program involves staff time administering Breathalyzer tests and expenses associated with locking up violators. Montana assesses participants in the program a nominal fee of $2 per test to offset costs. By contrast, most of the cost of ignition interlock programs is borne by the participants. In Massachusetts, participants pay the cost of the ignition interlock device—one Massachusetts vendor charges $60 a month—and a $30 fee to the Registry of Vehicles for periodic data downloads from the device. The downloads allow officials to check if a participant flunks the test, which may lead to additional punishments.

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Neither ignition interlocks nor the 24/7 Sobriety program has had a major impact on the total number of “alcohol-impaired driving fatalities” in Massachusetts and Montana. Deaths in Massachusetts as a result of alcohol-impaired driving fell about 10 percent between 2005, just before Melanie’s Law took effect, and 2014. Deaths in Montana went down about the same amount between 2011, just before the 24/7 program was launched, and 2014.