Just over a hundred years have passed since the first scientific report on drunk-driving crashes of motorized wagons in 1904 (U.S. Department of Transportation 1968). The number of alcohol-related deaths in that year is unknown, but in 2004, a century later, 16,694 Americans died on the nation’s highways in alcohol-related crashes. That is a 36% decline from the 26,173 alcohol-related fatalities in 1982 [National Highway Traffic Safety Administration (NHTSA) 1998]. The number of non-alcohol-related crashes has risen as the number of cars on the road (vehicle miles of travel) has increased, yet alcohol-related crashes have declined, saving an estimated 270,000 lives in the past two decades. Even so, drunk driving costs the nation $110 billion annually: $40 billion in direct costs and $70 billion in quality of life costs (Miller etal. 1997).

A Bit of History

Today, enforcement of drunk-driving laws is technologically complex, involving standardized behavioral tests and procedures for measuring blood alcohol concentration (BAC). These scientific techniques developed slowly over the twentieth century. Early in the century, a number of scientists worked on methods for detecting alcohol in blood (Jones 2000). A pioneer in the field was Widmark, a Swedish scientist, who between 1914 and 1932 described the relationship between BAC and the amount of alcohol consumed, based on the process by which the body absorbs and eliminates alcohol. Widmark developed his famous eponymous formula to calculate BAC from the amount of alcohol consumed (Andreasson and Widmark 1985).

In 1934, Heise published the first scientific paper directly relating alcohol consumption to driving. This, along with the work of Widmark, led Norway to adopt a per se BAC limit (0.05) in 1936, which defined impaired driving in terms of alcohol in the blood rather than the appearance and behavior of the driver. Even earlier, while the United States relied on officer testimony to obtain impaired-driving convictions, Scandinavian officers brought suspects to the police station to be examined by a physician who made the impairment decision.

Three important milestones occurred in the United States. In 1954, Robert Borkenstein, a professor at the University of Indiana, invented the Breathalyzer, the first practical, easily used breath-testing device (Borkenstein and Smith 1961). A decade later, he conducted the Grand Rapids study that compared crash-involved drivers with non-crash-involved drivers. This provided the means for plotting the relative risk of crash involvement as a function of BAC level (Borkenstein et al. 1974). The Grand Rapids study was repeated in 1995 and produced similar results. In 1977, Burns and Moskowitz (1977) developed a set of three standardized field sobriety tests (SFSTs) that are now widely used by officers to measure driver impairment.

These technological developments during the past twenty years have led to the passage of approximately 2,300 drunk-driving laws by state legislatures (NHTSA 2001). The National Committee on Uniform Traffic Codes and Laws (NCUTLO) issued a model state traffic law in 2000 (NCUTLO 2000) reflecting two decades of progress. Four laws formed the foundation for the current impaired-driving criminal justice system:

1. Implied consent laws, first adopted by New York in 1953, provide that accepting a driver’s license obligates the driver to submit to a BAC test if the officer has probable cause to believe that the driver is impaired. The penalty for refusal is administrative suspension of the driver’s license.

2. Administrative license suspension laws allow the officer to confiscate and the Motor Vehicle Department to suspend the license of any driver arrested for impaired driving with a BAC at or higher than the legal limit (currently 0.08). This law, adopted by Minnesota in 1976, responded to the courts’ inability to consistently suspend impaired drivers.

3. Driving-while-impaired (DWI) laws, which make it an offense to drive while impaired, were first adopted by New York in 1910. These laws require descriptive evidence of impairment from an officer (such as how the vehicle was operated and the appearance and behavior of the driver).

4. Per se laws make it an offense to drive with a BAC higher than a prohibited level. Indiana passed the first per se law in 1939, setting the limit at 0.15 BAC. As more and more states passed per se laws, that limit was gradually lowered to 0.10 BAC and then to 0.08 in 2000, following a congressional action. Now, all fifty states have adopted 0.08 as their legal BAC limit.

Based on these four primary laws, the standard impaired-driving arrest procedure follows four steps: (1) Identify and stop a vehicle likely being driven by an impaired driver; (2) interview the driver at the driver’s window to determine whether there is sufficient evidence to invite the suspect to step out of the car; (3) perform SFSTs to determine whether there is probable cause to make an arrest; and (4) arrest and transport the suspect to the police station for an evidential breath test. During the past three decades, the NHTSA has sponsored research on each of these steps to engender procedures useful to officers enforcing drunk-driving laws. This includes the development of observable signs that a vehicle is being driven by an impaired driver (Harris, Howlett, and Ridgeway 1979), the development of SFSTs (Burns and Moskowitz 1977), preliminary breath-test devices (PBTs) to be used in the field (Cleary and Rodgers 1986), and finally, standards for evidential breath-test devices (NHTSA 1992).

The current DWI enforcement system is substantially limited by several problems. Two recent reviews, one funded by NHTSA (Hedlund and McCartt 2001) and the other by the Traffic Injury Research Foundation of Canada (Simpson and Robertson 2001), have highlighted some issues faced by police in enforcing DWI laws. Hedlund and McCartt (2001) point to the need to (1) simplify arrest procedures to reduce the time required to apprehend and process offenders; (2) increase penalties to discourage breath-test refusals; and (3) provide improved training on the use of SFSTs and PBTs.

Hedlund and McCartt also emphasize the need for greater use of PBTs, particularly passive sensors that can detect alcohol in the expired air from a distance of six inches to identify heavy drinkers who are tolerant to alcohol and show few behavioral signs of intoxication. Sobriety checkpoints, where all drivers can be stopped and examined for impairment by the police under controlled conditions, have been strongly supported by the NHTSA and safety advocates. Police departments have been less enthusiastic, viewing them as expensive and as yielding too few DWI arrests (Fell, Lacey, and Voas 2004). Proponents argue that if the checkpoints were run with minimum personnel using passive sensors, they would be cost effective and produce greater deterrence to DWI than the traditional enforcement procedures (Voas, Lacey, and Fell 2005).

Recently, there has been an increasing concern with high BAC first offenders becoming repeat offenders, based on work by Simpson and colleagues (1996). They argue that most crash-involved drinking drivers have high BACs and that many are repeat offenders. This has stimulated interest and legislation aimed at controlling such drivers by increasing the DWI offense penalties and, ultimately, has led to lengthier license suspensions and, for multiple offenders, longer jail sentences. It also has increased the use of vehicle sanctions, such as vehicle impoundment, vehicle forfeiture, and registration suspension with license plate seizure or special plates (Voas and DeYoung 2002). Of these sanctions, vehicle impoundment has produced the strongest evidence for effectiveness in reducing recidivism rates.

Ignition alcohol interlocks, which prevent a driver with a BAC greater than 0.03 from starting a car, have been proved to reduce recidivism by 50% to 90% when installed on an offender’s vehicle (Voas et al. 1999).

Unfortunately, this positive impact is lost after the unit has been removed, and only 10% to 20% of eligible DWI offenders install the units (Voas and Marques 2003). Only when coerced by the threat of house arrest do as many as two-thirds of offenders agree to install the units (Voas et al. 2002).

Following prohibition, most states adopted twenty-one as the minimum legal drinking age (MLDA) (Toomey, Rosenfeld, and Wagenaar 1996). When the voting age was lowered to eighteen in response to the Vietnam War, however, twenty-nine states followed this trend between 1970 and 1975 and lowered their MLDA to younger than twenty-one (Mosher 1993). A series of research studies followed, demonstrating that the lower drinking ages increased crash involvements for the affected youth. This led to a reversal of the low MLDA trend and culminated in federal legislation—the Uniform Drinking Age Act—that resulted in all states adopting twenty-one as the MLDA by 1988 (Toomey, Rosenfeld, and Wagenaar 1996). Since that time, NHTSA has estimated that 900 lives are saved each year by the MLDA (NHTSA 2004).

Aside from the traffic safety benefit, the MLDA led to an increase in the attention to primary prevention of impaired driving through control of alcohol availability (Wagenaar and Holder 1996), price (Cook 1981; Chaloupka, Saffer, and Grossman 1993), and server interventions to promote ”responsible sales” practices (McKnight 1996). This was characterized by an expansion of the traditional drunk-driving prevention programs into the broader public health field. Consequently, police departments became more involved in enforcing ”zero tolerance” laws, which make it an offense for drivers age twenty and younger to have any alcohol in their systems. Police also began conducting ”cops in shops” programs (Century Council 2005), in which officers in civilian clothes act as clerks to apprehend underage alcohol purchase attempts. In addition, alcohol outlet ”stings” (University of Minneapolis 2000) are held, in which underage police cadets attempt to purchase alcohol, and party patrols are formed to break up teenage keg parties. Some police departments have a low enthusiasm for enforcing such underage and alcohol sales laws; however, recent research has shown that early onset of drinking (before age sixteen) leads to increased probability that the individual will be an impaired driver as an adult and will be more likely to become dependent on alcohol (Grant, Stinson, and Harford 2001; Hingson et al. 2002).

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