< Back to all interventions for Treatment of Alcohol Use Disorder
Driving While Intoxicated (DWI) Prevention Program
Intensive DWI intervention delivered while incarcerated plus post-release monitoring.
The San Juan County Driving While Intoxicated treatment program targeted first-time offenders to prevent subsequent instances of driving under the influence of alcohol. All participants were incarcerated for 28 days with random assignment to treatment or no treatment control. This intervention program provided evaluation, a comprehensive array of individual counseling (delivered with a motivational interviewing framework), group treatment, and post-discharge monitoring. Treatment during incarceration focused on alcohol use, misuse and dependence, health and nutrition, psychological effects of alcohol abuse, drinking and driving awareness, stress management, goal setting, family and domestic violence, and HIV/AIDs prevention. Post release, treatment participants received components of community reinforcement for an average of 6 months including weekly monitoring sessions of alcohol breath tests, action plan implementation, Alcoholics Anonymous (AA) attendance, job and educational referrals. Native American cultural activities and work release were available to participants.
Outcomes
Drinking outcomes for treatment participants significantly better than incarceration-only comparison group.
Participants in the San Juan County Driving While Intoxicated treatment program had a significant reduction in all alcohol outcomes compared to participants randomized to incarceration only. Treatment group participants reduced past 90 days number of drinks consumed by 110.3 drinks, number of drinking days by 11.6 days, and average blood alcohol content by 0.018 mM (as compared to 26.9 drinks, 3.3 days and 0.005 mM in the incarceration only group). These reductions persisted over the 6-, 12-, and 24-month follow-ups. However, no effect was observed on likelihood of re-arrest for DWI. There was also no comparison group that received neither treatment nor incarceration.
Costs
Given access to an established DWI incarceration program, there would be moderate start-up and ongoing costs.
Initial costs are estimated to be mid-range because the counselors are already most likely on staff at the facility and already provide some of the services. There would be a cost for someone to train staff in motivational Interviewing, for standardized assessments necessary for the interventions, and for 6 weeks of follow-up monitoring services. The initial intervention is delivered within the existing jail setting, so additional costs related to infrastructure would likely be small. The high number of elements of treatment and follow-up suggests that there would be moderate costs for non-judicial system staff time and to replenish supplies needed to deliver the intervention.
Cultural Engagment
Several Native American healing cultural elements were available.
This intervention employed the use of many cultural elements including sweat lodges, talking circles, access to Native healers and Native American church and “other interventions for Native Americans.” There was no Tribal involvement.
Participants
Young Adult, Adult, Senior; Native, Non-Native; Female, Male
Setting
Other
Delivery
Individual, Small Group, Face-to-Face
In this study, 77% of participants were Native Americans incarcerated in northwestern New Mexico.
Of the 234 participants, 77% were Native Americans and 13% were female, were randomized to receive the active treatment vs. incarceration only in the San Juan County Jail, a minimum-security jail in northwest New Mexico. Participants were recruited from court-defined first DWI offenders who had been sentenced to jail/treatment. The mean age of participants was 27 years, but no range was provided.
Staffing Needs
Not Specified
Credentials and background of counselors and case workers were not described.
Counselors and caseworkers were mentioned, but it was unclear what academic degrees they held. Counselors were trained in motivational interviewing.
Research Design
Randomized controlled experimental design
Developmental stage of research
This research with incarcerated DWI offenders is consistent with other research studies that demonstrate effectiveness.
The present study makes use of a reasonably large sample, a control group, and multiple follow-up time points extending to 2 years beyond the conclusion of the intervention, with results supporting its efficacy throughout those follow-ups. These results reflect the positive outcomes found in other treatment/incarceration research discussed in the article. The research base would be stronger if a non-incarcerated comparison group had been included in this study.
Potential
Program appears to be promising for first time Native American DWI offenders to reduce problematic alcohol use.
The San Juan County Driving While Intoxicated treatment program appears to be a feasible program to implement within justice settings serving other Native communities. The intervention shows good outcomes on alcohol variables over time, even for offenders who started treatment with higher risk profiles than the comparison group. There needs to be training of staff in motivational interviewing and extensive follow-up. The program may be even more beneficial if there was Tribal community input.
References
Woodall WG, Delaney HD, Kunitz SJ, Westerberg VS, Zhao H. A randomized trial of a DWI intervention program for first offenders: Intervention outcomes and interactions with antisocial personality disorder among a primarily American-Indian sample. Alcohol Clin Exp Res. 2007;31(6):974-987. https://pubmed.ncbi.nlm.nih.gov/17403067. https://doi.org/10.1111/j.1530-0277.2007.00380.x.
Kunitz SJ, Woodall WG, Zhao H, Wheeler DR, Lillis R, Rogers E. Rearrest rates after incarceration for DWI: A comparative study in a southwestern US county. Am J Public Health. 2002;92(11):1826-1831. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447336. https://doi.org/10.2105/AJPH.92.11.1826.
< Back to all interventions for Treatment of Alcohol Use Disorder