Getting to Zero: Exploring Effective Solutions for Long-Term Behavior Change of Impaired Drivers

Current Judicial Response to Impaired Driving

The justice system is somewhat inconsistent in its responses to impaired driving. While each state has its own set of laws and sentencing guidelines for various levels of impaired driving, most include the use of technology, education, and other interventions aimed at reducing this behavior. Narrowing it down further, each individual jurisdiction within a state, whether it is a county, parish, or municipality, often has its own “go-to” canned types of sentences for various levels of impaired drivers. Additionally, prosecutors may have their own discretion regarding the recommended sentences to which judges make decisions. The point is that impaired-driving laws and sentencing practices are complex systems based on discretion and sometimes professional and personal attitudes toward this habitual behavior. This complexity often hinders our ability to identify what might actually work to achieve our goals.

Incarceration is often our go-to response as an intervention for impaired driving. Generally, that is the way our system is set up: graduated sanctions as people’s behavior continues to get worse. We also have several other responses in our toolbox: community supervision, treatment, use of technology like ignition interlock, impaired-driving treatment courts (aka DWI courts), and other interventions that are too numerous to mention. We can argue about whether some sentences are too light or while others are too harsh, but that’s not the point of this article. In this article, we aim to explore whether the interventions we implement—whether punitive measures or alternative approaches —are truly effective in addressing this dangerous and habitual behavior. If our ultimate goal is Vision Zero, then why do we continue to use interventions that may have little or no impact on achieving this vision?

Our experience in working with jurisdictions across this country is that we deliver interventions that are complianceand program-driven. This begs the question: Does compliance-driven programming change behavior? The short answer is it depends on the individual. The keyword here is individual. It is unrealistic to expect everyone to respond equally to the same intervention, as we each have unique differences.

Let us pause for a moment and do a little exercise. Think about your own life when you’ve been required to make a significant change. Maybe it was a change in job, a health risk, a change in your family, or a habitual behavior. Whatever the circumstance, think about why you were required or why you wanted to make that change. When you set out to make the change, did you do it on your own, or did you have assistance in making that change? Were you given a plan with no options? Or did you have some say in your plan about how you wanted to go about making that change? Did you have anybody there to support you when things were going well or to offer guidance or recommendations when things weren’t going as planned? As you moved through that change, reflect on whether you struggled, whether it was relatively easy, or whether it was a little bit of both as life circumstances and other factors impacted that change in your life. Finally, if you were able to make that change, have you maintained the change? Or, if you didn’t meet your goal, can you identify factors that may have hindered your ability to achieve that goal?

We use this exercise as an insight builder. Change is hard; hard changes take time, support, and effective interventions. “One size does not fit all.” For change to be lasting and adherence based, it all comes down to individuality. Each person is shaped by their unique background— where they come from, how they were raised, the presence or absence of family support, values and belief systems, past trauma, and more. These factors, combined with daily life circumstances, influence our behaviors in both the short and the long term.

Let us get back to the topic at hand: impaired driving. Here is what we do know. Approximately two-thirds of first-time impaired drivers will never repeat this behavior. The initial arrest, the short stint in jail, the embarrassment, the cost, the potential impact on life, or whatever the negative impact had on them is detrimental enough that they never repeat this behavior. That leaves us with the one-third of those who will repeat this behavior. While there are ways for us to potentially identify the one-third, which we’ll discuss later in this article, we generally do not know who that population is. This repeat population is composed of the very folks whom we need to further investigate to identify interventions that may work for them. There are interventions that work in the short term, and there are interventions that change behavior long term. Unfortunately, there are also interventions that have little to no impact on changing this behavior. The very fact that impaired drivers repeat this behavior habitually clearly identifies that we have not addressed the underlying causes for their behavior, which is why they keep coming back.

The Issue of Repeat Impaired Driving Is Multifaceted

Why do some individuals continue the behavior of impaired driving, and how do system responses fall short of addressing their needs? There is a subset of the impaired-driving population that simply will not adhere to certain interventions. Think of these individuals as a “can’t versus won’t.” What we mean by that is there are underlying symptoms and factors that make change very difficult: substance use disorders, co-occurring conditions, insight and motivation to make the changes, for example. If we are not effectively treating those underlying symptoms and conditions, it is unrealistic to expect long-term behavior change for those individuals. Sometimes the system is at fault in that we apply an ineffective intervention that does not meet the needs of that individual. Interventions that do not match the individual’s needs can cause harm. Conversely, there is a portion of this population that simply will not adhere to those conditions and interventions because they do not want to. That is simply willful noncompliance. These individuals often feel that they do not have a problem, that they are not at fault, and that they have a judge problem. If people left them alone, they would be fine. That is their perception.

For others, compliance with conditions may be relatively easy to accomplish. Individuals who have extensive experience with law enforcement, probation, and the courts become very skilled and experienced at navigating that system. They become very good at telling people what they want to hear. They also often identify patterns in lack of supervision and/or detection, which enables them to continue undesirable behavior. While most would agree that impaired driving is one, if not the most, dangerous behavior in our communities, when put on supervision, these individuals are often on the highest caseload sizes. This means we often do not have the resources or staffing capacity to adequately supervise and hold these individuals accountable. Thus, the combination of all these factors often leads to these individuals “doing time,” i.e., completing their probation or other intervention without really changing their behavior.

In the previous paragraphs, we deliberately used two words to describe behavior change: compliance and adherence. Compliance is what we discussed earlier about impaired drivers on probation or other interventions just simply “doing time.” When interventions are centered around compliance—or simply “checking the box”—our primary goal for the individual is to follow the rules of the program or court order. While compliance is necessary, it is not what drives lasting behavior change. Incarceration embodies this concept. If jail changed behaviors, we would not have the recidivism rates for this population. Can we realistically expect people to change behavior if they are not invested in the process? Applying the same idea to other interventions, such as treatment, often leads individuals to learn how to “do the time” rather than actually engaging in treatment and transformation. Change is challenging, and merely showing up and going through the motions are not enough.

Adherence, on the other hand, is about genuine commitment to behavior change, driven by factors that matter to the individual. Using the treatment example again, adherence means aligning the intervention with the client’s stage of change to support accountable, lasting transformation. If we fail to tailor our approach to meet clients where they are, something essential may be missing, making true adherence difficult to achieve. Meaningful adherence improves when clients have a voice and a sense of choice, even if the options are limited. Think back to the exercise earlier in this article where you considered making a change in your own life—having a say in the plan likely made the process easier. When interventions rely on compliance-driven factors, especially in treatment, the focus often shifts to elements like time in treatment, dosage, completion of a specific curriculum, or the use of evidence-based practices. While these are important, they are not the best predictors for positive outcomes in treatment settings. One of the best predictors in achieving adherence and treatment progress is the therapeutic alliance—the connection between therapist and client. This relationship is crucial for fostering motivation and building skills within the client. When a strong alliance is established, it becomes the foundation of true adherence.

As discussed earlier, the key to creating lasting change lies in individualizing the intervention. This doesn’t mean we can’t have specific programs that address the needs of many people, but it does mean we need to consider how these interventions are applied, the expectations we set, and whether we are asking individuals to comply with or truly adhere to the program. Individualization can be achieved through the principles of risk-need-responsivity (RNR), which guide the “who,” “what,” and “how” of the intervention.

The “who” refers to assessing risk and matching the intensity of the intervention to the individual’s likelihood of repeating the behavior. For those considered high risk—who are likely to struggle with standard supervision or continue engaging in the same behaviors that led them into the justice system—more intensive interventions are necessary to address their specific needs effectively.

The “what” addresses the individual’s specific needs. Impaired drivers often enter the system with underlying factors that contribute to their ongoing undesirable behaviors. These factors, known as criminogenic needs, may include substance use disorders, mental health issues, antisocial behaviors and attitudes, associations with criminal peers, and other characteristics. By focusing our interventions on these criminogenic needs, we give individuals the best opportunity to address these underlying issues, thereby increasing their chances of long-term success.

The “how” refers to responsivity, which is about delivering the intervention in a way that meets the individual’s unique needs. To do this effectively, we must understand the specific characteristics of the person in front of us, including their demographics, learning style, motivation (or lack thereof), cultural background, cognitive functioning, values, beliefs, and more. Tailoring the intervention to these factors is essential. For instance, placing two individuals from very different backgrounds in the same treatment program may not be effective if the program is designed to fit the background of only one of them. Yet, this is a common practice in intervention delivery.

To properly apply the RNR model, it is crucial to screen and assess individuals accurately and promptly. Several factors influence the risk of continued impaired driving. The most obvious is prior involvement in the justice system related to impaired driving: The more frequently a behavior is exhibited, the more likely it is to be repeated. An often-overlooked factor is prior nonimpaired-driving offenses, such as reckless driving, driving without a license, or other traffic violations, which can indicate antisocial attitudes toward highway safety. Additionally, in some jurisdictions, impaired-driving offenses are pleaded down to lesser charges like reckless driving, potentially masking the true history of impaired driving.

Another significant factor is a history of involvement with alcohol or other drugs. Untreated symptoms related to substance use tend to worsen over time, substantially increasing the risk of continued impaired driving. While not always considered a general factor, mental health and mood adjustment disorders are primary indicators of risk for impaired driving. According to Resonsibility.org, 45 percent of repeat impaired drivers have at least one diagnosed mental health disorder, with the percentage being higher for women.

Finally, resistance to and noncompliance with past or current justice system involvement is another critical factor. This population often minimizes their behaviors and the underlying issues that lead to repeated offenses. There is frequently a high degree of ambivalence, negative attitudes toward law enforcement and the justice system, and a tendency to downplay substance use and mental health problems.

Impaired driving can stem from various causes, including substance abuse disorders, mental health issues, or occasional poor decision-making. Addressing these behaviors requires tailored interventions. Screening and assessment represent two essential processes with key differences while serving a similar purpose. The primary purpose of screening focuses on identifying individuals who may be at risk or potentially have a substance use disorder. Screening instruments are brief, and the preliminary process seeks to determine if further assessment is needed; it does not provide a definitive diagnosis. Various professionals can conduct screenings in many settings, including the courts.

The assessment gathers comprehensive information about substance use patterns, related behaviors, and problems. Completed by professionals with specialized training and qualifications, a comprehensive clinical assessment provides a diagnosis, which informs treatment planning. The evaluation involves utilizing validated tools to examine substance use history, co-occurring mental health disorders, biomedical conditions, continued use potential, recovery environment, and motivation to change. To avoid wasting valuable time and resources, it’s often more effective to conduct a screening first to determine if a full assessment is necessary for an individual.

It is essential to recognize that not all risk assessments are equally effective for impaired drivers. The level of risk posed by impaired drivers varies—some may have a history of repeated offenses, indicating a higher likelihood of future incidents, while others may have no prior criminal record. Distinguishing between high-risk and low-risk offenders allows for better allocation of resources, ensuring that those at higher risk receive more intensive interventions.

Risk assessments need to be validated specifically for the population they are intended to evaluate. Many assessments are general in nature and may not capture the specific risk factors discussed earlier. It is crucial to use a risk assessment tool that accurately identifies the risks and criminogenic needs of impaired drivers, enabling us to match individuals to interventions that suit their risk and need levels. Additionally, a clinical assessment is vital for identifying specific treatment needs.

Conducting both risk and clinical assessments as soon as possible after arrest is critical for intervening quickly. Addressing the public safety risk associated with impaired driving and providing necessary treatment services without delay ensure that the system responds promptly to the issue. When services are delayed, expecting habitual behavior to change is unrealistic, as individuals are likely to continue driving impaired, often without detection.

Curated Solutions for the Impaired Driver

Once criminogenic risk and clinical needs assessments are completed, suitable interventions can be determined based on the individual’s level of risk and need. This approach is often referred to as the quadrant model. Although there are various ways to deliver interventions within this model, we will outline the key elements of each category along with some examples.

For high-risk, high-need impaired drivers, the focus should be on accountability, treatment, and habilitation. These individuals have two primary priorities: getting them into treatment services to achieve clinical stability and providing close supervision to ensure public safety. By working together, treatment and supervision professionals can identify other quality-of-life needs and connect individuals to services that address these areas of risk. High-risk, high-need individuals are best suited for an Impaired Driving Treatment Court (IDTC), which provides a structured environment where they receive the care and accountability necessary for success.

The collaborative team in an IDTC, led by a judge, understands the unique needs of each individual and addresses issues in real time. High-need individuals are more responsive to positive reinforcement or incentives, and when challenges arise, practitioners should focus on adjusting services rather than imposing punitive measures. As discussed previously, highneed individuals typically fall into the “can’t” rather than “won’t” category—they often lack the capacity to make better choices until they receive the necessary support and services to improve their decision-making.

A high-risk, low-need track focuses primarily on supervision and accountability. While some habilitative services may be helpful, individuals in this group do not require the same level of care as those with high needs. High-risk, low-need individuals typically fall into the “won’t” rather than “can’t” category, meaning their poor decisions are more likely due to choice rather than an underlying substance use or mental health disorder. As a result, responses to their behavior often involve negative reinforcement or punishment. Intensive probation or monitoring programs are appropriate for this group.

Low-risk, high-need impaired drivers present with few criminogenic needs and little, if any, involvement in the justice system. However, clinical assessments often identify substance use and/or mental health disorders that require long-term, individualized care. There also may be some habilitative needs related to their substance use. Because they have high needs, these individuals respond better to incentives than to punishment. They should not be mixed with high-risk individuals to avoid the risk of learning negative behaviors, which could increase their own risk factors.

Lastly, low-risk, low-need individuals do not require close supervision or treatment services. The less intervention with this group, the better, as unnecessary involvement could expose them to higher-risk or higher-need individuals, which is counterproductive. In fact, this group likely represents the two-thirds of the impaired-driving population described earlier. However, emerging research suggests that screening these individuals for risky substance use or potential clinical diagnoses could help identify the one-third who may become repeat offenders. If no issues are indicated, meeting the minimal requirements mandated by statute is all that should be done for this group.

By applying interventions based on an individual’s risk and needs, we move closer to fostering adherence rather than mere compliance. To achieve adherence, it is important to ensure that goals are realistic, barriers to participation are minimized, individuals have a say in setting their goals and choosing their care, trust is established, and an alliance is formed with a practitioner. Additionally, the individual should develop skills to address problematic areas by gaining insight into their past behaviors and building motivation for change.

Unfortunately, we often fail to connect people with interventions that are likely to be effective for them. A common pitfall is using interventions that are not evidence- based or have minimal supporting research—this is a critical mistake. Every intervention should be supported by research that demonstrates its effectiveness. If the evidence is mixed or lacking, we should not rely on that intervention to produce long-term behavior change. Another issue is the use of generic, onesize- fits-all interventions, which can lead to undertreatment or overtreatment. When we take this approach, we waste valuable time, resources, and money on interventions that are unlikely to work or could even exacerbate the problem.

To ensure the impact of any intervention, we must measure outcomes and confirm that evidence-based practices are being used effectively. This means continuously assessing whether the practices employed are achieving their intended results.

A Call to Action

In summary, our appeal is for you to carefully assess each impaired driver and thoughtfully match them with services based on their risk and needs. Evaluate the interventions available in your jurisdiction to determine whether they are evidence- based and being used as intended. If they lack research support or are being misapplied, consider why they are still in use and how practices can be adjusted for proper implementation. Identify any gaps in services and take steps to develop interventions that address the specific risk and need levels of impaired drivers.

While incarceration may be necessary to protect public safety in some cases, we should not deceive ourselves into thinking that harsher penalties alone will deter repeat impaired drivers. We need to ask ourselves the original question: What is our goal in combating impaired driving? If the answer is Vision Zero, then we must think more broadly about what truly creates lasting behavior change.