epeat drunk drivers cause a disproportionate amount of harm on our nation's roads. Although they make up only 1 to 2 percent of all U.S. motorists on the U.S. roads, repeat drunk drivers account for 27 percent of all driving fatalities every year and 50 percent of deaths on weekend nights. Stricter sanctions and an increased likelihood of serving prison or jail time have not been successful solutions, at least in part because the very intoxication that makes their driving illegal and dangerous also reduces their susceptibility to deterrent threats.

Researchers suggest that court-ordered treatment combined with license sanctions and incarceration could lower the recidivism rate among repeat drunk drivers. In 1998, the newly-created Office of Community Corrections within the Massachusetts Trial Court contracted with BOTEC to conduct this study to assess the feasibility of establishing a new type of facility dedicated exclusively to the long-term treatment and aftercare of multiple (as defined by 3 or more offenses) OUI offenders within the Commonwealth of Massachusetts.

The goals of the study included: assessing the prevalence of multiple OUI offenders under different forms of correctional supervision; profiling current multiple OUI programs in Massachusetts and elsewhere; ascertaining program costs to treat and incarcerate offenders; determining the impact of sentencing guidelines on the disposition of OUI offenders; analyzing assessment programs, sentencing, and treatment laws to identify inherent system blocks to the establishment of a dedicated, secure facility; and, determining the characteristics of the most successful treatment programs.

At the Massachusetts forum, Michael Forcier from the BOTEC Analysis Corporation discussed the results of a study BOTEC was completing for the Massachusetts Trial Court. The study, "Repeat Drunk Driving Intermediate Sanctions and Secure Facility Feasibility Project," focused on the feasibility of establishing a secure facility dedicated to providing treatment as well as incarceration for drunk driving offenders. Here the study is summarized.

Findings and Conclusions

Without changes in sentencing practices for alcohol-involved offenders, any new facility would have difficulty filling its slots: not because of any shortage of offenders in need of treatment, but because many of those who need it will not accept it unless the alternative is incarceration. The denial characteristic of all addictive disorders means that many of those who objectively need treatment are not subjectively aware of that fact or refuse to allow that awareness into their conscious thinking. Even those who are cognitively aware that they have a problem may still be unwilling to undergo the often painful process of behavior change.

The "demand" for residential alcohol treatment among the population of alcohol-involved offenders depends on at least three factors: the number of offenders at various stages of their alcohol abuse careers; the availability, attractiveness and cost of treatment; and the pressure put on alcohol-involved offenders by the sentencing practices of the Massachusetts courts. Since, by law, treatment cannot be imposed involuntarily, demand for treatment will reflect the choices of offenders. Those who are aware of their problems and desire to recover from them may choose treatment even without external pressure - if it is sufficiently available, affordable and effective.

But in the more common case of those in denial or unwilling to endure the discomfort of the recovery process, willingness to enter treatment will depend strongly on how unpleasant the alternative is. Faced with the alternative of, say, a year in a house of correction, the vast majority of alcoholic offenders would choose virtually any treatment alternative. But given the choice between two weeks in jail or a month of residential treatment followed by a year of close supervision - and given that the jail stay is paid for by the public while the treatment must be paid for by the offender - a large proportion of offenders will, and do, choose to just "do the time" and then get back to unrestricted drinking and driving.

As long as judges remain unwilling to impose substantial incarceration terms on multiple drunk drivers, the system lacks the leverage to induce participation in treatment. This lack of demand does not reflect a lack of need, either from the personal or the societal viewpoint. There is no shortage of people who need treatment and whose untreated behavior creates a social need for them to be treated, but there is a shortage of incentives for them to accept treatment. Thus, the first step in creating a new residential treatment facility for alcohol-involved offenders is to change the applicable sentencing practices in ways that allow such a facility to operate at or near capacity.

One approach would be the extension of guideline sentencing to multiple OUI offenses and to multiple assault, property or public-order offenses involving alcohol abuse. The guideline sentencing would create fairly stiff sentences for those crimes but allow a treatment alternative. In effect, this would deny judges their current discretion to impose sentences too lenient to create any incentive for alcoholic offenders to accept treatment. Alternatively, judges could be left with their current discretion, but encouraged to amend how that discretion is used. In either case, educational efforts would be needed within prosecutors' offices, since prosecutors always retain discretion about the charging decision. The persuasion efforts should focus on four topics: the nature of alcohol-related disorders; the high social cost of alcoholic offenses; the capacity of treatment to improve matters, and the need to create incentives for treatment entry.

It is not unreasonable for a judge or a prosecutor to be unwilling to impose a long period of incarceration on someone who, when sober, is a good citizen and human being, but is unable to control either his or her drinking or behavior while under the influence.
It is, however, unreasonable to allow those with alcoholic disorders, and related conduct to remain both free and untreated. Unless judges and prosecutors can be brought to understand the role of sentencing in inducing treatment entry, retention and compliance, they will continue to act as enablers of alcoholic misbehavior.