1. WELCOME OKLAHOMA IMPAIRED DRIVING Prevention SUMMIT REDUCING RECIDIVISM February 28 th 2012

2. IDENTIFYING THE ISSUES What Works What Doesn’t

3. CONTACT Ray Caesar LPC, LADC Ray Caesar LPC, LADC Director of Addiction Specialty Programs Director of Addiction Specialty Programs Oklahoma Department of Mental Health & Substance Abuse Services Oklahoma Department of Mental Health & Substance Abuse Services P.O. Box 53277 P.O. Box 53277 Oklahoma City, Oklahoma 73152-3277 Oklahoma City, Oklahoma 73152-3277 rcaesar@odmhsas.org rcaesar@odmhsas.org rcaesar@odmhsas.org Office 405-522-3870 Office 405-522-3870 Fax 405-522-4470 Fax 405-522-4470

4. CURRENT INTERVENTIONS COST

5. Costs for DUI and related offenses are intended to: ~ Pay for the services provided, ~ Discourage the behavior of driving while intoxicated.

6. COST The cost for DUI or a related offense in Oklahoma and nationally is estimated to be $10,000.00.

7. COST BAIL $150.00 to $2,500.00

8. COST TOWING $60.00 to $1,200.00

9. COST IMPOUND $100.00 to $1,200.00

10. COST INSURANCE Automotive insurance coverage will increase for 3 to 5 years. These cost increases will be double to quadruple basic costs.

11. COST MODIFIED LICENSE FEE $175.00

12. COST LEGAL FEES $2,500.00 TO $25,000.00

13. COST FINES & COURT COSTS $300.00 TO $1,200.00

14. COST ADSAC ASSESSMENT $160.00 TO $175.00

15. COST ADSAC COURSE $150.00 TO $360.00

16. COST VICTIMS IMPACT PANEL $50.00

17. COST CLINICAL INTERVENTIONS $0.00 TO $13,000.00

18. COST MONITORING LEG BRACELET $300.00 PER MONTH

19. COST MONITORING INTERLOCK $115.00 TO $160.00 INSTALLATION $65.00 PER MONTH $35.00 REMOVAL

20. COST REINSTATEMENT FEE $85.00 TO $250.00

21. COST ADDITIONAL COSTS TIME OFF WORK JOB RESTRICTIONS LOSS OF EMPLOYMENT

22. COST TOTAL $10,000.00

23. PROBLEM AVERAGE OKLAHOMA INCOME MEDIAN INCOME $42,979.00 < POVERTY16.2%$14,570.00 (Two person household) 2010 US Census

24. TRENDS

25. REFUSAL TO TEST

27. TRENDS In the last five years license revocations for Refusal to test have continued to increase while other revocation categories have decreased.

29. TRENDS GENDER

31. TRENDS Between 1996 and 2010 DUI and related convictions for males fell by 4%. Between 1996 and 2010 DUI and related convictions for females rose by 4%.

32. TRENDS The rates for DUI & related offense by gender indicates the numbers of male offenders are reducing, while the numbers of female offenders continue to increase. This pattern is most pronounced in rural areas.

34. TRENDS AT TWO YEARS Without ADSAC as an intervention, females are less likely to recidivate than males With ADSAC as an intervention, female and male recidivism rates are almost identical

35. TRENDS FEMALE DUI OFFENDERS As DUI arrest rates have continued to reduce for approximately twenty years the proportion of female DUI offenders has increased dramatically. Overall DUI arrest rates have not declined in rural areas. Female DUI offenders in rural areas present one of the greatest challenges to the system. The American Journal of Drug and Alcohol Abuse, 2009, Vol. 35, No. 1, Pages 24-27

36. TRENDS MALE & FEMALE OFFENDERS

37. TRENDS THE MALE DUI OFFENDER PROFILE Unmarried, undereducated, underemployed Age late twenties to early thirties Poor anger management & stress coping skills Initial attention of law enforcement due to aggressive not erratic driving

38. TRENDS THE FEMALE DUI OFFENDER PROFILE Unmarried, separated or divorced Age twenty to fifty Unemployed but seeking employment Arrested secondary to a vehicular crash Evaluating, Treating and Monitoring the Female DUI Offender William White & Maya Hennessey, Illinois Department of Transportation

39. TRENDS MALE TO FEMALE DUI OFFENDER 15.7% of females aged 18 to 25 met criteria for alcohol abuse or alcohol dependency. 26.3% of males aged 18 to 25 met criteria for alcohol abuse or alcohol dependency. Evaluating, Treating and Monitoring the Female DUI Offender William White & Maya Hennessey, Illinois Department of Transportation

40. TRENDS MALE TO FEMALE DUI OFFENDER At the highest rates of consumption males and females report driving while impaired at the same rates. DUI arrests are the single greatest category of alcohol related crimes for women. Evaluating, Treating and Monitoring the Female DUI Offender William White & Maya Hennessey, Illinois Department of Transportation

41. ???????????????? Who gets a DUI?

42. WHO GETS A DUI 1% of all licensed drivers are arrested for DUI & related offenses each year, more than any other crime. NHTSA

43. WHO GETS A DUI 25% to 40% of30% of the population the populationconsume 90% of never drinkthe alcohol ======================================== * * * * ======================================== Of this group only 30% or (10% of the total population) are physically dependent

44. WHO GETS A DUI Access to ADSAC services may be required for almost anyone living in Oklahoma *Only a very small percentage of the population will not be possible candidates for ADSAC services. *

45. WHAT WORKS EFFECTIVNESS OF THE CURRENT SYSTEM

46. WHAT WORKS ANNUAL CONVICTIONS FY 1996 – FY 2010

47. WHAT WORKS After a predictable increase in arrests between 2003 and 2005 the rate stabilized. In 2009 the rate began to fall dramatically.

49. WHAT WORKS EVIDENCE BASED BEST PRACTICES

50. WOULDN’T IT BE NICE IF… From the assessment process we could: ~ Identify static and dynamic risk factors related to alcohol and other drug use ~ Identify Pathological Using Patterns

51. WOULDN’T IT BE NICE IF… From the assessment process we could: ~ Assess truthfulness ~ Assess comprehension ability ~ Identify mental health issues

52. WOULDN’T IT BE NICE IF… From the assessment process we could: ~ Clearly and accurately identify recidivism risk ~ Double check the results

53. WOULDN’T IT BE NICE IF… TODAY WE CAN!

54. WHAT WORKS Drivers Risk Inventory-revised DRI II Defendant Questionnaire DQ

55. WHAT WORKS The DRI II consistently places high in studies of DUI assessment instruments. When cost, ability to screen for drugs as well as alcohol, truthfulness scales, and research to determine reliability and validity are considered, then the DRI II places highest. National Highway Traffic Safety Administration Review of Screening Instruments and Procedures for Evaluating DUI Offenders AAA Foundation for Public Safety 2002 The Illinois DUI Assessment Instrument Project & National Highway Traffic Safety Administration

56. WHAT WORKS What Works

57. ASSESSMENT DRIVEN FIFTY STATES AND WASHINGTON DC (2010) 30Assessment driven process66% 7Modified assessment driven process15.5% 6Offense driven13.3% 2No statewide regulation4.5% 6UnknownNA

58. WHAT WORKS Institute of Medicine Intervention Spectrum

59. WHAT WORKS

60. PREVENTION I - UNIVERSAL II - SELECTIVE III - INDICATED

61. WHAT WORKS INDICATED Targeted to high risk individuals identified as having minimal but detectable signs and/or symptoms of the high risk behavior. This intervention is for those known to have involvement (DUI)

62. WHAT WORKS TREATMENT IV - IDENTIFICATION V – STANDARD TREATMENT

63. WHAT WORKS What Works

64. WOULDN’T IT BE NICE IF… We could accurately identify offender need

65. WOULDN’T IT BE NICE IF… We could refer offenders to the most appropriate interventions

66. WOULDN’T IT BE NICE IF… We could separate offenders by level of severity

67. TODAY WE CAN TODAY WE CAN!

68. TODAY WE CAN SIX INTERVENTION CATEGORIES INTERVENTION CATEGORY IEducation Only IIEducation Only IIIOutpatient IVIntensive Outpatient VResidential Treatment

69. TODAY WE CAN SIX INTERVENTION CATEGORIES INTERVENTION CATEGORY IEducation Only IIEducation Only IIIOutpatient IVIntensive Outpatient VResidential Treatment

70. TODAY WE CAN In a random 100 offenders 40% Minimal risk to recidivate 30% Moderate risk to recidivate 20% Problem risk to recidivate 10% Severe risk to recidivate

71. PROBLEM What Doesn’t Work

72. WHAT DOESN’T WORK OFFENSE DRIVEN SYSTEMS

73. WHAT DOESN’T WORK ONE SIZE FITS ALL INTERVENTIONS I ENT IO

74. PROBLEM The average number of times an offender drives while legally intoxicated for each DUI & related arrest is 1 in 200. In some communities this is as high as 1 in 2000. NHTSA

75. PROBLEM Water boils at 212 degrees Fahrenheit Gasoline freezes at -238 degrees Fahrenheit

76. PROBLEM Nationally, about 1/3 of all DWI & related offenders are repeat offenders Average 32% Low 21% in Iowa High 47% in New Mexico NHTSA

77. WHAT DOESN’T WORK PUNISHMENT

78. WHAT DOESN’T WORK A 10% INCREASE IN INCARCERATION YIELDS A 2% TO 4% DECREASE IN RECIDIVISM What Work Effective Recidivism Reduction and Risk-Focused Prevention Programs February 2008

79. WHAT DOESN’T WORK TOO MANY INTERVENTIONS or IF ONE IS GOOD THEN TEN MUST BE GREAT

80. WHAT DOESN’T WORK DISJOINTED OR UNCONNECTED INTERVENTIONS

81. WHAT DOESN’T WORK TOO MUCH TIME BETWEEN OFFENSE AND INTERVENTION

82. WHAT DOESN’T WORK PSUEDO SCIENCE or COMMON SENSE DOES NOT ALWAYS MAKE SENSE BUT IT IS ALWAYS COMMON

83. PROBLEMS WITH EXIT SURVEYS Repeat offenders allow approximately six years between offenses. American Journal of Forensic Psychology

84. PROBLEMS WITH EXIT SURVEYS Driving history prior to the first offense was predictive of future recidivism. American Journal of Forensic Psychology

85. WHAT WORKS ADSAC

86. RECONVICTION RATES AT TWO YEARS 2008 to 2010

88. ADSAC AT TWO YEARS 13.1% recidivism for those not initiating the ADSAC process 5.6% recidivism for those completing the ADSAC process

89. ADSAC Reconviction rates after 24 months Reconviction Rates Without Assessments 13.1% With Assessments Initiated 6.4% With Assessments Incomplete 7.5% With Assessments Complete 5.6% The DUI reconviction percentage among offenders w/o assessments was 134% more than among those with completed assessments.

90. ADSAC AT TWO YEARS 5.6% recidivism for those completing the ADSAC process

91. ADSAC VIRGINIA 1 year study of DUI offenders on probation and assigned to VASAP program. 9% recidivism during probation 5% recidivism after probation 15% total 5.6% recidivism for those completing the ADSAC process at 2 years Recidivism Rate Comparison Study Rappahannock Area Alcohol Safety Action Program

92. ADSAC MISSOURI At two years post intervention there was a 16% recidivism rate 5.6% recidivism for those completing the ADSAC process at 2 years Missouri Department of Mental Health 1999

93. ADSAC TENNESSEE Recidivism at one year8.7% Recidivism at two years10.4% Recidivism at three years18.3% Recidivism at six years52.3% Recidivism at ten years61.5% 5.6% recidivism for those completing the ADSAC process at 2 years Little, Baker, McCarthy, Davison & Urbaniak, An MRT Based Cognitive Behavioral Treatment for fiirst-time DUI Offenders: Two and Three year Cohort of Davidson County, Tennessee Offenders With a Comparison to the Prime For Life Program March 2010

94. ADSAC RECONVICTION RATES BY OFFENSE TYPE 2008 to 2010

96. ADSAC AT TWO YEARS The recidivism rate for drug offenders is 60% greater than that of alcohol offenders.

97. ADSAC RECONVICTIONS for ADSAC COMPLETIONS AFTER TWO YEARS DRUG OFFENDERS 3.8% an almost 60% reduction ALCOHOL OFFENDERS 2.5% an almost 50% reduction

98. ADSAC RECONVICTION RATES BY AGE OF OFFENDER 2008 to 2010

100. ADSAC AT TWO YEARS The recidivism rate for the 21 to 25 year old age group is the highest, followed closely by the 26 to 54 year old age group. The lowest rate of recidivism is found in the 16 to 20 year old age group.

101. FOOD FOR THOUGHT CALIFORNIA Each year of age decreased recidivism risk by 2.1% Full time employment decreased recidivism risk by 37.6% 1995 California State Report

102. FOOD FOR THOUGHT CALIFORNIA Each prior conviction increased recidivism risk by 26.9% Each 0.01% increase in BAC increased recidivism risk by 5.4% Being male increased recidivism risk by 57.5% 1995 California State Report

103. FOOD FOR THOUGHT Excessive drinking rather than alcoholism creates the majority of alcohol related problems. The prevalence of alcohol dependence among excessive drinkers in New Mexico, Alcoholism: Clinical & Experimental Research, Jan. 2007

104. FOOD FOR THOUGHT CALIFORNIA Completion of Tx decreased recidivism risk but, multiple Tx completions increased recidivism risk 1995 California State Report

105. FOOD FOR THOUGHT Alcohol related fatalities were eight times more likely to have had a DUI/DWI conviction in the five years prior to the crash New England Journal of Medicine 1994

106. FOOD FOR THOUGHT Repeat offenders are overrepresented in fatal crashes. Drivers with prior convictions are 4.1 times more likely to be involved in a fatal traffic accident. The risk of involvement in a fatal automobile accident increases with the number of prior DWI & related arrests. NHTSA

107. THE FUTURE WHERE TO GO FROM HERE

108. THE FUTURE COOPERATION

109. THE FUTURE COORDINATION

110. THE FUTURE MAKING THE DIFFICULT DECISIONS

111. THE FUTURE DEVELOPING A PLAN

112. THE FUTURE ENSURING FOLLOW THROUGH

113. CONTACT Ray Caesar LPC, LADC Ray Caesar LPC, LADC Director of Addiction Specialty Programs Director of Addiction Specialty Programs Oklahoma Department of Mental Health & Substance Abuse Services Oklahoma Department of Mental Health & Substance Abuse Services P.O. Box 53277 P.O. Box 53277 Oklahoma City, Oklahoma 73152-3277 Oklahoma City, Oklahoma 73152-3277 rcaesar@odmhsas.org rcaesar@odmhsas.org rcaesar@odmhsas.org Office 405-522-3870 Office 405-522-3870 Fax 405-522-4470 Fax 405-522-4470