The most sobering fact about drunk driving is the numbers. According to the National Highway Traffic Safety Administration (NHTSA), alcohol related accidents claimed 10,322 lives in 2012, an increase of 4.6% from the previous year. The majority of those drivers had a blood alcohol content (BAC) of .15 or higher. In 2010, 1.4 million drivers were arrested for driving under the influence or alcohol or narcotics. According to the CDC, that is only about 1% of the self-reported 112 million incidents of adults driving under the influence. To put some scale to that figure, the population of Mexico is about 108 million.
 

There are numerous sanctions in place to prevent people from driving under the influence: license suspension, vehicle impoundment, and staggered sentencing are all used as a method to prevent another occurrence. None, though, seem more effective than the use of interlock ignition devices (IIDs). When installed, research from the NHTSA has found that IIDs have been associated with as much as a 70% reduction in DUI arrests.
 

According to the National Conference of State Legislatures, all states have some sort of IID laws. Fifteen (Alaska, Arizona, Arkansas, Connecticut, Hawaii, Kansas, Louisiana, Nebraska, New Mexico, New York, Oregon, Tennessee, Utah, Virginia, and Washington) now have mandatory provisions for all offenses. Connecticut, whose measure passed unanimously in May, 2014 closed a loophole that will now require thousands of offenders to use the devices. The loophole was one that allowed first-time offenders to attend an alcohol education program and have his or her license suspended for a period ranging from three months to a year. After successful completion, the offender’s legal record could be wiped clean.
 

In 2005, New Mexico started requiring IIDs for all first-time offenders. As a result, the use of the devices leapt from 162 in 2002 to nearly 12,000 in 2010. Studies showed that those who had an IID installed were 77% less likely to be arrested for driving under the influence than those who don’t. The state also realized a 37% reduction in DUI re-arrests. During that time period, alcohol-related crashes declined by 31%, injuries from alcohol-related crashes decreased by 41%, and DUI fatalities dropped by 38%. 
 

In 2006, Massachusetts implemented Melanie’s Law, a provision that increases penalties and sanctions for those convicted of operating under the influence (OUI). One of the stipulations of the law is that any driver who gets a second or subsequent OUI and is eligible for license reinstatement (the driver must prove that he or she does not have access to public transportation), he or she will be required to install an IID to any vehicle owned, leased, or operated by the driver, including an employer’s vehicle, for a period of two years. According to the Massachusetts Registry of Motor Vehicles, on the third anniversary after implementation, police had been making more DUI arrests (about 20% more), but far fewer were for repeat offenses. Nearly 4,400 drivers who received a second or higher conviction of OUI enrolled in the Registry’s IID program. Of those, 553 completed the program, and only two of them had been arrested again. At that time, the data found that 117 failed out, 217 withdrew voluntarily, and 3,797 remained in the program.

 

Complications & limitations

The solution might sound obvious, but the situation is not cut and dry. There is the matter of the judicial system, for one. In New Mexico, for example, approximately one-third of those arrested for DUI are not convicted. There is also the matter of a driver claiming that he or she does not have a vehicle in order to avoid having a device installed. There are also those who intend to drive but say that they won’t. States are taking measures to address some of these concerns. Texas, for example, has a program that requires certain offenders to have an IID installed before posting bail.
 

One of the most limiting aspects of IID use, as discussed in a systematic review of the literature titled “Effectiveness of Ignition Interlocks for Preventing Alcohol-Impaired Driving and Alcohol Related Crashes” published by the Task Force on Community Preventive Services in the American Journal of Preventive Medicine, is the relatively small number of people who participate in a program. After getting a DUI, people generally have three options: choosing not to drive, enrolling in an IID program, or driving illegally. Many drivers (contrary to expectations) prefer the latter thinking that statistics might provide the protection from being caught. 
 

Efforts continue to develop programs that lessen the options for avoiding IID use. One study mentioned in the review suggested that more severe sanctions should be put in place. For example, one study found that if confronted with the option that electronically monitored house arrest was offered as an alternative to installing an IID, approximately two-thirds of offenders would opt for the IID.
 

Another limiting factor the review found was that many states only require the program for multiple-time offenders. States that have mandates requiring all first-time offenders to have an IID installed on the driver’s car have seen drastic declines in drunk driving. In 2009 there were 161,074 DUI convictions in California. Of those, 73% were first-time offenders and 27% percent were repeat offenders. That may sound as if the first time offenders simply made a mistake, but data from the CDC found that a first-time offender had driven under the influence more than 80 times before being caught.
 

There is also the matter that a sanction tends to work better when used in conjunction with another.  The Task Force stated in their review that data suggest that offenders who had an IID installed on their vehicle were at far greater risk of recidivism, but simply being enrolled in a program does not tend to lead to long-term changes in the behavior of drinking and driving. When IIDs are removed, the recidivism rate tends to return to what it had been before installation.

 

Swedish Interlock Trials

Sweden, a nation of 9 million, of which two-thirds have a driver’s license, has very strict sanctions and limits compared to many other industrialized countries. In the mid-'90s, the Swedish Parliament adopted Vision Zero with the long-term goal of eliminating traffic deaths all together. A national trial used IIDs in an effort to improve the quality and reduce the hazards of commercial driving by taking preventive measures. The trial involved a taxi company, a bus company, and a trucking company. The trial grew, and several smaller ones emerged throughout the country. As of 2011, the number of IIDs used in Swedish commercial vehicles has grown to 55,000.
 

The Swedish Interlock Trial for offenders started in 1999 with a deadline of December 2010. Between 4,000 and 5,000 people participated, and more than half (55%) were diagnosed with either abuse or dependency. While Sweden offers offenders the option to be in enrolled in an IID program, it is under the provision that they have a medical assessment to monitor for alcohol abuse. (The offender must show that he or she has been sober for a year.) Other results, as reported in another article in the American Journal of Preventive Medicine, were lowered recidivism, reduced accidents and hospital visits, fewer sick days paid by the National Health, and reduced harmful alcohol consumption that was confirmed by audit and blood tests.
 

Another evaluation of a Swedish IID program that included an intensive treatment component found that the 171 participants had no incidents of recidivism as opposed to the nearly 5% per year among those who did not participate. The Swedish government has considered making IIDs mandatory on all cars, an idea endorsed by both Saab and Volvo.

Sweden is not the only advocate for treatment being used in conjunction with an IID program. The Century Council, which is funded by distillers, believes that IID programs must include a treatment component while the device is installed to allow for the chance of behavioral changes. A publication by the NHTSA also suggests that there should be a greater tie between IID and treatment programs. 
 

In December 2013, the NHTSA released Model Guideline for State Ignition Interlock Programs, which emphasizes several key program features to maximize effectiveness. These features include legislation, education, program administration, and implementation.

One element the guideline suggests is for states to implement an agency with “clear authority and responsibility” for managing the IID program. These responsibilities include establishing the administrative procedures and the program’s regulations as well as maintaining oversight of the manufacturers and IID service centers.

States should also eliminate—or at least minimize—the eligibility requirements that might prevent an offender from participating in the program as well as eliminate options for offenders to avoid from participating and establish the amount of time for which the device must be used. In light of the statistics found from the New Mexico study and other states that require the sanction, the guideline suggests that states should also mandate that all offenders convicted of alcohol impaired driving be required to install an IID, a suggestion also supported by the CDC.

By Michael Grohs, Contributing Editor