Program Profile: San Juan County (N.M.) DWI First-Offense Program

This is a program for people arrested for the first time for driving while intoxicated (DWI). The program seeks to reduce DWI rearrest rates. The program is rated Promising. The treatment group showed statistically significant improvement on all three measures of alcohol use (total consumption, drinking days, and average blood–alcohol content), compared with the control group. However, there was no statistically significant difference between groups on rates of DWI rearrests.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals

The San Juan County DWI First Offender Program is designed to work with court-defined first-time persons convicted of driving while intoxicated (DWI). The goal of the program is to reduce DWI rearrest rates.

Target Population

The program is run by San Juan County, which is in northwestern New Mexico, and targets court-defined first-time DWI offenders. The participants come from rural and tribal settings.

Program Components

The program was introduced to counter high rates of alcohol-related motor vehicle crashes. Those convicted for the first time are incarcerated in a minimum-security facility for 28 days. While incarcerated, program recipients receive a multicomponent treatment that is culturally appropriate (for example, Native Americans have access to a sweat lodge and talking circles).

There are nine specific treatment components:

• Alcohol use, abuse, and dependence
• Health and nutrition
• Psychological effects of alcohol abuse
• Drinking-and-driving awareness
• Stress management
• Goal-setting for the immediate future
• Family issues and alcohol
• Domestic violence
• HIV/AIDS prevention

There is a work release program for clients who are employed. Participants receive individual counseling, group programs, and postdischarge monitoring for 3 to 12 months. The postdischarge monitoring program includes personal action plan implementation, weekly monitor meetings, alcohol breath tests, Alcoholics Anonymous meetings attendance, job referrals, and vocational education.

Throughout the program, motivational interviewing techniques are used in client–counselor interactions. Motivational interviewing is a nondirective, client-centered counseling style that emphasizes nonconfrontational communications. Counselors are trained in motivational interviewing. This technique rests on several assumptions, including the following:

• Confrontational/negative messages are counterproductive to bringing about change
• Most people move through a series of steps before they are ready to change
• Change is internally motivated rather than externally imposed
• Education/knowledge alone will not effect change
• A key to motivating change is to reduce ambivalence
• The individual can, in fact, make a change [Fleming 2002]

Study

Woodall and colleagues (2007) conducted a randomized trial to assess the effectiveness of San Juan County’s DWI incarceration and treatment program. More specifically, this study examined the role antisocial personality disorder (ASPD) played in the treatment program for persons convicted for the first time of driving while intoxicated (DWI) in a region with a predominantly American Indian population. It tested the reduction of drinking levels and DWI recidivism and also examined how responsive the ASPD participants were compared with non–ASPD participants and controls.

The sample consisted of 305 people who have been convicted of DWI for the first time who volunteered to participate in the study. Recruitment into the study ran from January 2000 to February 2003. The study population was 76.0 percent American Indian and 86.9 percent male. Fifty-two of the participants were diagnosed with ASPD. Participants were randomized to the treatment group (n=177) or the control group (n=128). An analysis of the comparability of the two groups found that the treatment group had more individuals with ASPD and individuals with significantly more severe histories of drinking and driving. The ASPD group had heavier drinking at baseline. The control group participants were incarcerated for 28 days (as were the treatment group), but they received none of the program treatment components. The control group was afforded work release when employed.

Assessment included a baseline assessment and assessments at 6, 12, and 24 months postdischarge. Self-report data on drinking and driving was collected; DWI rearrest data was available for 274 participants. The Diagnostic Interview Schedule was used to assess presence of alcohol dependence and ASPD. Form 90 was used to assess the primary drinking measures (standard ethyl-alcohol consumption [SEC] units, number of drinking days, and average blood–alcohol content [BAC]). The Drinker Inventory of Consequences collected data on problems related to alcohol use over a past period of time. Analyses controlled for the impact of missing data. Rearrest data was available for up to 5 years postdischarge for some participants.

Subgroup Analysis

Woodall and colleagues (2007) examined the role that antisocial personality disorder (ASPD) played in the treatment program for first offenders convicted of driving while intoxicated. Among program participants, they found that ASPD participants showed greater improvement over time than did non–ASPD participants; however, the differences between the groups were not statistically significant.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Fleming, Michael F. 2002. Clinical Protocols to Reduce High-Risk Drinking in College Students: The College Drinking Prevention Curriculum for Health Care Providers. Bethesda, Md.: U.S. Department of Health and Human Service, National Institute on Alcohol Abuse and Alcoholism.

Kunitz, Stephen J., W. Gill Woodall, Hongwei Zhao, Denise R. Wheeler, Robert Lillis, and Everett Rogers. 2002. “Rearrest Rates After Incarceration for DWI: A Comparative Study in a Southwestern U.S. County.” American Journal of Public Health 92(11):1826–31. (This study was reviewed but did not meet CrimeSolutions criteria for inclusion in the overall program rating.)

Following are CrimeSolutions-rated programs that are related to this practice:

Motivational Interviewing for Substance Abuse

A client-centered, semidirective psychological treatment approach that concentrates on improving and strengthening individuals’ motivations to change. The practice is rated Effective. Individuals in the treatment groups significantly reduced their use of substances compared to those in the no-treatment control groups.

Evidence Ratings for Outcomes

Drugs & Substance Abuse - Multiple substances

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?