Working To Solve California’s DUI Problem

Posted on: November 21, 2017

By Katherine E. Watkins, M.D., M.S.H.S.

Katherine E. Watkins is a Santa Monica psychiatrist and senior natural scientist at the RAND Corporation. The overall goal of her research is to improve the quality of care for individuals with behavioral health disorders, by developing, implementing, and evaluating innovative treatments and treatment models of health care delivery.

Let’s start with the good news. In recent years there has been a decline in alcohol-related traffic fatalities across the United States. How much of a decline? How about an impressive 40 percent over the last 20 years. There are many factors contributing to this success story, including:

• Decreasing blood alcohol concentration (BAC) limits
• Limiting judicial discretion in sanctioning
• Instituting administrative license revocation
• Establishing new driving under the influence (DUI) program requirements

Despite the trend, the hard data still causes alarm.

Data through 2013 suggest that the alcohol-related traffic fatality rate in California is now increasing.

• In 2012, alcohol-involved crash fatalities in California increased 7.3 percent
• This was followed by an increase of 2.4 percent the following year. In 2013, 1,197 people in California died of alcohol-related traffic incidents.

These facts led three of my colleagues and me to write a Perspective research study for the RAND Corporation to explore the fundamental question: Can California do more to address repeat DUI offenders and the harms caused on public health and safety.

In our study we approach the issue from a fresh perspective. Specifically, we note that California’s current approach to addressing DUIs largely focuses on reducing the probability that individuals drive while drinking. Although the current approach has had important benefits in reducing alcohol-related traffic fatalities, we argue in this Perspective that future approaches will also need to better target the problem drinking that often underlies impaired driving and DUI convictions.

We also note that there are concrete steps that California legislators should consider in order to further reduce the harms from alcohol misuse. They may want to authorize studies, we suggest, to determine which approaches (e.g., administrative sanctions, ignition interlock devices, 24/7 Sobriety programs, pharmacotherapies, or some combination) work best for first-time versus reoffenders, or for those with an alcohol use disorder versus those without. It will be imperative that these studies look beyond traditional DUI recidivism outcomes and examine other consequences associated with alcohol misuse, such as domestic violence and other injuries and accidents.

Our conclusion is important for every Californian: The bottom line is that alcohol misuse and dependence can have terrible consequences that go far beyond the individual who drinks. The DUI conviction is a prime opportunity for California to address the problem of alcohol misuse. With the development of new treatments for alcohol use disorders and expanded coverage for substance abuse treatment under the Affordable Care Act, it is time for California to address the problem drinking that underlies many episodes of DUI recidivism. California can, and must, do more.

Please visit the RAND Corporation website to download a PDF of Perspective.

Posted in: Public Policy