Alcohol-related fatalities have significantly decreased over the past 25 years, but alcohol-impaired driving continues to kill more than 17,000 individuals per year—accounting for 40% of all traffic fatalities.1 Sustained public education campaigns and toughened laws have led to dramatic decreases in the number of social drinking drivers. As the pool of social drinking drivers decreases, “hard-core drinking drivers” constitute a larger portion of the impaired driving offender population.2
States have called upon addiction professionals to evaluate those arrested for impaired driving in order to identify high-risk drivers, but the accuracy of these evaluations has often been compromised by reliance on self-report data and imperfect instruments. Particularly troublesome is that the percentage of retrospective alcohol dependence diagnoses triples when impaired drivers are re-evaluated five years following their first arrest.3 This article describes efforts in the state of Illinois to enhance the quality of such evaluations, and highlights a recent study that sheds light on the profile of the hard-core drinking driver.
One state's response
Illinois has a long history of collaboration across multiple agencies to reduce alcohol-related driving fatalities. Between 1982 and 2001, toughened laws, assertive law enforcement and prosecution, an informed judiciary, assertive monitoring by probation officers, rigorous gatekeeping of licensure reinstatement by administrative hearing officers in the Secretary of State's office, and mandated professional evaluation and treatment all contributed to a 60% reduction in Illinois’ alcohol-related fatalities.4 Even in the face of such success, calls grew for a more sophisticated approach to the evaluation and management of the state's driving under the influence offenders.
Historically, evaluators have been asked to answer three questions related to the DUI offender: 1) Does this offender have a problem in his/her relationship with alcohol and/or other drugs? 2) If so, what is the duration and level of severity of this problem? 3) What combination of educational and treatment services has the greatest probability of resolving these problems? While such questions are appropriate in the context of addiction treatment, they do not in and of themselves answer two broader questions: 1) What degree of risk does this offender pose to the safety of the public (risk defined as DUI recidivism and future involvement in alcohol-related crashes involving damage to property, personal injury, and death)? 2) What community strategies can best be combined to lower the threat to public safety posed by this offender?
In an effort to provide better answers to these questions, the Illinois Department of Transportation, in collaboration with the Administrative Office of the Illinois Courts, the state Division of Alcoholism and Substance Abuse, and the Illinois Secretary of State, created a DUI Task Force and a Risk Reduction Work Group. The latter was charged in 2000 with the responsibility of examining the state's DUI evaluation process. This committee's work was performed under the direction of the Institute for Legal and Policy Studies at the University of Illinois.
Over the ensuing years, the Risk Reduction Work Group conducted a literature review of the DUI evaluation process,5 created a scientific advisory panel, conducted a 2001 national survey of state DUI evaluation processes/instruments (47 states participated), and conducted focus groups with Illinois prosecutors, judges, probation officers, evaluators, treatment specialists, and administrative hearing officers.
Two major findings stemmed from these early steps. First, we found that states varied widely in their evaluation protocol. There were differences in which state agency was responsible for alcohol-related public safety, in who conducted the evaluation of DUI offenders (e.g., a private contractor versus a probation officer), and in DUI evaluation instruments. Twenty-three of 47 states mandated use of one or more instruments, with the Driver Risk Inventory-II (DRI-II) and the Mortimer-Filkins test being the most commonly mandated evaluation tools. We found a total of 33 evaluation instruments in use, with only half the states reporting that they were satisfied with the instrument they were using.
Second, multiple stakeholders shared concerns that the integrity of DUI evaluations was being compromised by reliance on self-reports, inconsistent access to criminal and driving/insurance records, and instruments that did not collect critical areas of information (e.g., histories of drug use other than alcohol). There was also concern in states in which DUI evaluation was the province of the private sector that competition for defense attorney referrals downgraded the rigor of the evaluation process (i.e., those agencies with reputations for rigorous assessment were not getting referrals). There was a particular concern that existing evaluation instruments/processes did not identify those offenders who posed the greatest threat to public safety and therefore should receive the greatest intensity of supervision resources. This led the Risk Reduction Work Group to identify those qualities of an ideal evaluation instrument and to explore whether any existing instrument met those criteria.