Driving Under the Influence is a Great Concern
Although progress has been made, the impaired driving problem continues to be a great concern. The persistent drunk driver is believed to be one of the greatest threats to public safety.
More than 1.46 million drivers were arrested in the United States in 2006 for driving under the influence of alcohol or other drugs. This number represents an arrest rate of one DWI arrest for every 139 licensed drivers in the United States.
One in three Americans will be involved in an alcohol related crash in their lifetime.
Each year nearly 11,000 people die on our roadways due to impaired driving. That would equal 21 jumbo jets crashing each year.
One day’s drunk driving totals: 1,440 injuries and 29 deaths.
In Colorado there were 173 alcohol impaired driving fatalities in 2008, representing 32% of all fatalities, up from 30% in 2007. http://www.nhtsa.gov
Q. What can an alcohol Ignition Interlock (Interlock) do about the problem?
“Research shows that alcohol interlocks reduce recidivism among both first offenders and repeat offenders, including hardcore offenders (also known as persistent/chronic drinkers and repeat offenders who repeatedly drive after drinking with extremely high blood alcohol concentrations and are resistant to change this behaviour). More than 10 evaluations of interlock applications have reported reductions in recidivism ranging from 35 – 90%” (Voas and Marques 2003; Vezina 2002; Tippetts and Voas 1997; Coben and Larkin 1999).
Q. If Interlocks are so good at reducing recidivism, then what’s the problem?
Numerous studies demonstrate that alcohol interlocks have a beneficial impact on recidivism as long as the device is installed in the vehicle. Specifically, existing studies converge at the finding that once the device is removed, recidivism rates return to levels comparable to rates of those who did not have an interlock installed (Beirness 2001; Beirness et al. 1998; Jones 1993; Popkin et al. 1993; Coben and Larkin 1999; Marques et al. 2001; DeYoung 2002; Raub et al. 2003).
Q. What is the relationship between Interlocks and treatment?
Alcohol Interlocks serve as a nexus between criminal justice sanctions and substance abuse
treatment, by effectively restricting an offenders’ driving privileges while giving the offender the
opportunity to learn how alcohol consumption affects behaviour (Beirness 2001).
While treatment for alcohol abuse can be a lengthy process with setbacks and relapses, the alcohol
interlock provides a safety net to greatly reduce the likelihood that such relapses do not result in
impaired driving (Beirness et al. 1998).
Alcohol Interlocks were never intended as a treatment for alcohol abuse, thus the installation and use of an alcohol Interlock device alone cannot be expected to result in a long-term change in the amount and extent of alcohol consumption (Beirness 2001).
Ultimately, the relationship between alcohol Interlocks and treatment providers should be
strengthened as part of an Alcohol Interlock Program. More research examining the beneficial effect
of the integration of rehabilitation and Alcohol Interlock Programs is needed (Beirness et al. 2003).
Experts believe a greater tie between Interlock sanctions and substance abuse treatment should be
encouraged, because the integration of the two strategies mutually reinforce the likelihood of a
reduction in impaired driving behavior. (NHTSA, 2009).
“Methods for combining Interlock Programs with treatment should be explored further as a potential means of extending the effectiveness of Interlocks beyond the period during which they are
installed” (Task Force on Community Preventive Services, 2011)
Q. What is Interlock Enhancement Counseling (IEC)?
IEC is a brief intervention for DWI clients who have an interlock on their vehicle.
Based on evidence-based principles that combine cognitive behavioral treatment with motivational
interviewing/enhancement. IEC consists of ten hours of individual and group counseling over a 5-month period. Specifically, 4 individual sessions (30 minutes each, about once a month) and 4 group session (2 hours each, about once a month).
IEC can be used along with traditional DWI education and therapy or can also be used as a stand-alone program. IEC is compatible with any DBH approved DWI curriculum.
IEC is intended to increase clients’ chances of being successful while on and off the interlock.
A major component of the program is the discussion of the individual’s own performance on the interlock and the therapeutic process of changing their drinking and driving behavior while on the interlock as well as when the device is removed.
The program is manualized and includes a provider guide and a participant’s workbook.
Q. How is IEC different than Level I or Level II education or therapy?
IEC is not intended to be a comprehensive DWI education or therapy program. It is specific to the client’s
experience with the interlock. However, it is possible that upon successful completion of IEC, hours may count toward the client’s Level II therapy requirement.
Q. Why Interlock Enhancement Counseling (IEC)?
Implementation of IEC is an excellent opportunity to have a positive impact on an already identified high risk
DWI offender population, further reduce recidivism levels and increase public safety.
“The record of breath tests logged into an ignition interlock has been found to be an excellent predictor of
future DWI recidivism risk. Offenders with higher rates of failed BAC tests have high rates of post-ignition
interlock recidivism (Marques, 2008c).
The primary goals of IEC are to reduce the number of failed starts, eliminate driving non-interlock equipped
vehicles and prevent DWI recidivism once the interlock is removed.
Utilizing evidence based approaches that combine cognitive behavioral treatment with motivational
interviewing/enhancement, counselors meet with clients both individually and in an IEC group to address
interlock specific issues.
Interlock drive log data is used clinically to educate, provide feedback and support positive behavior change.
The IEC model was built on a pilot program called Support For Interlock Planning (SIP) conducted in Texas in 2003. SIP showed promise that a brief intervention, using a motivational enhancement approach and interlock data, could facilitate behavior change of DWI offenders using interlocks (Timken, Marques 2001)3
Q. Why treatment agencies should implement IEC?
Since virtually all DWI offenders have to participate in Level I or Level II services as a condition of their
probation sentence and/or driver’s license reinstatement, this is an opportunity to target those highest risk
offenders (high BAC first offenders and repeat offenders).
The treatment agency already staffs individuals who have experience and clinical expertise in treating substance
use disorders, conducting screening, clinical assessment, education and therapy. Since treatment agencies already
have minimum standards they comply with, as a condition of their licensure with DBH, there is assurance that the
provision of IEC services is done by individuals skilled and competent to do so.
High BAC and repeat offenders often present with an array of issues, such as co-occurring disorders, that are vital
to take into consideration in the provision of IEC and traditional DWI education and therapy services.
For those DWI offenders where it may be appropriate, a licensed DWI agency has the ability to count IEC hours
toward the clients Level II Therapy requirement.
Implementation of IEC may provide an additional source of revenue for agencies. When IEC hours count toward
current Level II Therapy requirements the additional cost to clients, and revenue to agencies, would not be much.
However, some clients may participate in IEC who do not need to take Level II therapy or have already completed
Level II therapy, this will be the greatest source of additional revenue for agencies.
Q. What do the proposed DBH rules say that agencies need to do?
The DBH Substance Use Disorder Treatment Rules are currently under revision. Proposed rules are
anticipated to become effective some time in 2012.
Screen DWI clients at admission for interlock requirements.
Agencies licensed to provide DWI education and treatment will need to offer interlock specific education and
treatment services to those clients who are restricted to the use of an interlock device by the DMV.
Agencies will have those clients participating in IEC sign consents to facilitate counselor access to the clients
interlock drive log.
Treatment planning for those clients with an interlock requirement will need to incorporate interlock
counseling (for those clients participating in IEC).
The specific details of the process will be written in DBH policy and will include such things as who is
eligible, what is meant by screening and how to screen (simply by asking a few key questions of the client),
what information should be incorporated in education classes, obtaining IEC training, use of consents,
accessing, and interpreting interlock drive logs, and strategies for encouraging client participation and
identification of incentives.
Q. What will agencies need to do?
The DBH policy, which will coincide with the effective date of the proposed rules, will include specific
guidelines for implementation. Generally, agencies will start by increasing their knowledge about the interlock
device. Counselors who will be working with IEC clients should attend one of the DBH sponsored one-day IEC
trainings. Discussion around the logistics of implementation is included in the IEC training. The agency will
develop policies and procedures for compliance with the relevant DBH rules and policy. There will be minimal
data entry requirements. Initially, IEC specific information will be entered in the notes section on the DRS.
Eventually; there will be a couple of new fields to complete. The agency will need to decide how they will staff
the individual sessions and the groups that are part of IEC. Those counselors providing IEC are required to have a
minimum CAC II and have had training in Motivational Interviewing.
Q. How will agencies get interlock drive log data?
There are five interlock vendors authorized to provide services in Colorado. Those vendors have agreed to allow
counselors access to their web based system in order to access clients’ interlock drive logs. In accordance with
applicable laws, clients must sign consents in order for agencies to access this data. Interlock vendors will issue 4
counselors a user ID and password to gain access to the data on their secured website. In addition to the complete
interlock drive log being available; a summary report will be made available to make it easier for counselors.
Interlock vendors have a tutorial on their website for assistance in interpretation of the drive logs.
Q. Do clients have to take IEC? And what are the incentives?
Clients do not have to take IEC. However it is recommended that the counselor encourage the client to participate
in the protocol. The counselor can describe common incentives for participation in IEC.
Receiving support around their interlock
Experiencing reduced problems while on and off the interlock
Reduce the probability of recidivism, emphasizing the cost of even a first DWI is estimated to be about
$10,000
The potential to complete treatment five weeks sooner and have the 10 hours count toward their Level II
Therapy requirement
Problems while on the interlock can result in an extension of the interlock requirement resulting in further
costs to the client.
Q. When can a client take IEC?
DWI offenders can take IEC at any point during their DWI education or treatment program, as long as they are
driving an Interlock-restricted vehicle. It can be taken concurrent to Level II education or Level II therapy. IEC
can also be a stand-alone. Some DWI offender will have already completed Level II and want additional support
with their interlock. Some DWI offenders who have experienced continued problems with their interlock are
facing a one-year extension of their interlock requirement. Dept. of Revenue, hearing officers may take successful
completion of IEC into consideration in determining the length of that extension
Q. When and how can the IEC hours count toward Level II Therapy requirements?
There is the possibility that successful completion of IEC may count as all additional required hours if the client is
a Track B client (52 hrs). This is possible if the agency’s clinical assessment indicates that no other specialized
services are needed.
The IEC hours may count as part of the required hours for Track C (68 hrs) or Track D (86 hrs) clients. Again,
this is possible if the agency’s clinical assessment indicates that no other specialized services are needed
IEC can run concurrently with education/therapy. In this case, because IEC is considered to be clinically
indicated, clients can take education and IEC concurrently and/or can also attend their Level II therapy group and
IEC concurrently.
For those clients that successfully complete IEC, and no further specialized services are indicated, the agency
would record IEC hours on the DRS as Level II non-intensive outpatient therapy hours completed. Until such
time as specific fields are created in the DRS, the agency can include the 10 hours along with other Level II
therapy hours completed and record a comment in the “notes” section that indicates 10 of the therapy hours was as a result of successful completion of IEC.
Q. I have other questions? I have suggestions for additional information to include in this FAQ.
Please email questions and suggestions to Christine.flavia@state.co.us
References:
Alcohol Interlock Curriculum for Practitioners, TIRF, http://aic.tirf.ca/section1/index.php
Beirness, D.J., Simpson, H.M., Mayhew, D.R. (1998). Programs and policies for reducing alcohol-related motor
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