At Suhre & Associates, LLC, we believe that everyone is entitled to their rights, and those rights should be defended to protect their future. However, we do not condone drunk driving in any circumstance. This DUI Prevention Guide serves as a source of information – learn about the dangers and consequences of drunk driving, prevention, alcoholism, and rehabilitation.
- About Drunk Driving
- Consequences of DUI
- DUI Recidivism
- Blood Alcohol Content
- Alcoholism and Rehabilitation
I. About Drunk Driving
Every year, drunk driving claims more than 10,000 lives, according to the National Highway Traffic Safety Administration. To put this in perspective, someone is killed in a drunk driving crash every 53 minutes on average. Nearly one-third of all traffic deaths are caused by drunk driving. Apart from the loss of life, someone is injured every two minutes as the result of a DUI (driving under the influence) accident caused by themselves or another individual, and drunk-driving accidents create approximately $199 billion of entirely preventable costs annually.
This human suffering and economic impact arises from a relatively small number of individuals, as only about one out of every 2,000 automobile trips is taken by someone driving under the influence of alcohol. Nevertheless, this seemingly small amount of behavior is one of the major causes of death and injury on our roadways. About one-third of drunk-driving issues – arrests, crashes, deaths, and injuries – come from repeat offenders.
According to Mothers Against Drunk Driving (MADD), up to 2 million people on the road at any given time have accumulated three or more drunk-driving offenses. Between 50 and 75 percent of these repeat offenders have already had their licenses taken away. Clearly, despite tougher laws and awareness campaigns—according to MADD, drunk-driving fatalities been reduced by half since 1980— drunk driving persists. In this guide, we will explore the DUI problem, its root causes, and prevention.
II. Consequences of DUI
Drunk driving falls under the legal classification of driving under the influence (DUI) or operating a vehicle impaired (OVI). DUI/OVI laws apply to impairment arising from alcohol and illegal narcotics, as well as legal drugs and medications. For the offender, the consequences of driving while under the influence are severe. Punishments include imprisonment, revocation of driving privileges, and fines and other punishments.
Generally an offender receives multiple forms of punishment. Offenders under the age of 21 may face even more severe penalties. Many other consequences, both legal and otherwise, may ensue following a DUI/OVI conviction. Most states also impose penalties if a suspected driver refuses to comply with testing.
The most serious punishment that can be applied for DUI/OVI is imprisonment. Laws vary by state, but in all states first-offense DUI/OVI is classified as a misdemeanor and may be punishable by up to six months in jail. Many states mandate jail time even on a first offense. While the mandatory first-offense minimum can be a matter of only a few days, most states increase punishments for offenders with high blood alcohol content (BAC) at the time of arrest, with “high” minimum limits ranging from 0.15 to 0.20 percent, compared to the legal limit of 0.08 percent in all states.
Subsequent offenses often result in jail sentences of several months to a year, again with more severe penalties for offenders whose blood shows higher BAC. DUI/OVI can be classified as a felony if the driver killed or injured someone or if it is the driver’s third or fourth offense. In these cases, jail sentences of several years are not uncommon. Sentences depend on state law, the facts of the case, and the discretion of the judge at trial, but increasing public intolerance of these crimes encourages judges to impose longer jail terms.
Revocation of Driving Privileges
A DUI/OVI offender stands a good chance of having his or her license suspended. Even if the court does not take this action, some states give the Department of Motor Vehicles latitude to do so. In Ohio a first offender faces 6 months to a 3 year license suspension, a second offender faces 1-5 years, and a third offender faces 2-10 years. The idea of a license suspension is to ensure the offender does not get back behind the wheel of a car and onto the road. To this end, some states take additional steps, which may include confiscating the automobile or canceling the car’s registration, temporarily or permanently.
Alternatively, the state may mandate that an ignition interlock device be installed in the offender’s car. This device requires the driver to blow into a handheld alcohol sensor attached to the car’s ignition. If the device measures BAC above a preset level (usually 0.02 to 0.04 percent), the car won’t start. Offenders ordered to install ignition interlock devices are responsible for all associated costs—installation, monthly fees, and removal.
Fines and Other Punishments
Courts may impose fines ranging from $500 to $2,000 for DUI/OVI, and fines are generally imposed in addition to other sanctions like imprisonment and license suspension.
A number of states give judges the latitude to mandate teaching and prevention programs, treatment for substance abuse, assessment of the offender for alcohol or drug dependency or addiction, community service, and victim restitution. The judge may recommend these steps instead of jail time or fines, most likely for a first offender, or combine them with other penalties. In Texas, for example, minors convicted of a DUI must perform community service, in addition to other penalties.
A minor arrested for driving while under the influence of alcohol or drugs will not get any breaks from punishment and may in fact face more punishment than will an adult. Because the legal drinking age is 21 in most states, the drinking itself is an additional crime on top of the driving offense.
Some states set lower blood alcohol limits for minors than the standard 0.08 percent for adults, typically 0.02 percent. The state may impose adult sentences on minors, and underage DUI offenders are likely to have their licenses suspended for one year on the first offense.
In addition to legal penalties, the driver’s insurance company may cancel his or her automobile insurance policy or dramatically increase the cost of coverage because of the points that a DUI conviction adds to the driving record. The insurance company is also likely to cancel the insurance policy if the insured’s driver’s license is suspended. Employment may become an issue for those convicted of DUI/OVI.
More than likely, any occupation that requires driving, such as school bus or delivery van driver, a sales job for which a company vehicle is issued to the employee, or a travel job requiring the employee to fly to a distant location and rent a car, will be closed to a DUI/OVI offender. Victims of an accident caused by a DUI/OVI offender may file civil lawsuits, apart from the criminal proceedings, seeking compensation from the drunk or drugged driver for property damage, bodily injuries, or loss of life. Finally, a DUI/OVI charge stays on a person’s record for many years, meaning that the stigma and consequences of this conviction will last a long time.
Refusal to Give a Blood, Breath, or Urine Sample
Simply being arrested for suspicion of DUI/OVI can result in penalties if the suspected drunk driver refuses to take a blood, breath, or urine test. Most states have an “implied consent” law that requires a driver arrested for driving under the influence to give a blood, breath, or urine sample. These laws also require the driver to provide multiple breath samples, if requested by the police. Refusal to provide any requested sample results in an automatic suspension of the suspect’s driver’s license for three to 12 months (depending on the state), even if the underlying DUI-related charge does not yield a conviction. Some states permit additional penalties.
III. DUI Recidivism
DUI recidivism is a significant challenge in the war on drunk driving. Approximately one-third of drunk-driving issues are caused by repeat offenders. According to MADD, up to 2 million people on the road at any given time have accumulated three or more DUI/OVI offenses. Between 50 and 75 percent of these repeat offenders have already lost their driver’s licenses. In fact, the original mission of MADD was to prevent repeat offenders and chronic alcohol abusers from committing drunk-driving offenses because that was considered the crux of the DUI problem.
Legal punishments for DUI/OVI offenses have steadily increased over the past decades, yet this has not proven sufficient deterrent to prevent repeat offenses. Some say that harsher penalties serve only to hammer social drinkers (people who are not alcoholics or compulsive substance abusers) on their first DUI offense, while failing to impact the hard-core drinker who repeatedly becomes intoxicated and then climbs behind the wheel of a vehicle.
So What’s the Answer to DUI Recidivism?
One method that has proven to significantly reduce the rate of DUI recidivism has been the use of ignition interlock devices (IIDs). IIDs require the driver to blow into a handheld alcohol sensor attached to the car’s ignition before starting the vehicle. If the device measures blood alcohol content (BAC) above a preset level (usually 0.02 to 0.04 percent) in the breath sample, the car won’t start. IID’s are generally required on all vehicles to which the offender has access (his or her own vehicle as well as that of a spouse or other person sharing the offender’s residence).
Because of the dramatic success rate of these devices when they are used, research is underway to develop cheaper and more effective versions.
- One alternative hopes to use near-infrared tissue spectrometry and measure light absorption into body tissue as a means of detecting the level of alcohol in the blood. The goal is to integrate this system into vehicle controls, such as the start button or steering wheel, and to take multiple, accurate readings in less than a second.
- Another advance in the technology anticipates using the concentrations of carbon dioxide and alcohol from the driver’s exhaled breath in the vehicle cabin as a measure of dilution, rather than requiring the deep lung breath sample of standard breathalyzers. The system will be designed to take instantaneous, unobtrusive readings as the driver breathes normally and to accurately and reliably distinguish between the driver’s breath and that of the passengers.
Both these systems claim to be able to measure intoxication continually from the point of starting the car until the end of the drive.
Meanwhile, individual states are evolving other strategies to address recidivism.
- In California, where 27 percent of convicted DUI offenders are repeat offenders, the DMV provides law enforcement agencies with the driver’s license numbers of multiple-DUI offenders whose licenses have been suspended or revoked. The agencies then supply enforcement officers with the names, addresses, photos, and vehicle descriptions of these individuals for increased scrutiny and monitoring.
- In Santa Fe, New Mexico, the law allows police to seize and sell the vehicles of offenders following a third DUI conviction.
- In Ohio, a second offender is required to have an ignition interlock device. It is also an option to wear SCRAM (secure continuous remote alcohol monitoring) bracelets as a condition for limited driving privileges. The SCRAM device is an ankle bracelet that gathers data at the surface of the skin and can detect the presence of alcohol in the wearer’s body.
Yet individual responsibility plays an equally important role alongside law enforcement in the fight to curb DUI/OVI offenses and make our roads safer. One component of individual responsibility has to do with self-monitoring and avoidance of reckless behaviors, and it also includes intervening when we see others about to take irresponsible chances.
Whether for one’s self, for a friend, or for a stranger on the road, there is much each of us can do to keep drunk or otherwise impaired drivers off the roads. Following are tips for a variety of situations. The easiest DUI/DWI to prevent is your own—don’t drive while impaired or over the legal limit. This doesn’t mean you can’t go out and enjoy a drink, but it does require a bit of advance planning.
- Before going out with friends, or at the latest before beginning to drink, agree on a designated driver who will abstain from drinking alcoholic beverages and take responsibility for driving everyone home at the end of the evening.
- If going out on your own, take a cab or public transportation to and from the bar, restaurant, or party. If you plan to visit multiple destinations, consider hiring a car for the evening to drive you wherever you need to go.
- If you find yourself at the end of an evening having indulged a bit too much and lacking a friend to drive you home, get a cab, train or bus, or check into a hotel within walking distance to sleep it off.
How do you know if you’ve had too much to drink?
It is possible to roughly calculate one’s own blood alcohol content. However, performing the math without a calculator in a social situation can be challenging. Fortunately, for most of us the signs of intoxication are fairly recognizable. They include:
- Flushed skin
- Bloodshot eyes
- Slurred or loud speech
- Blurred or double vision
- Inability to walk in a straight line, tendency to bump into things
- Inability to sign your name normally
Unfortunately, if you’ve had too much to drink, your judgment is probably too impaired to allow you to recognize the signs. Instead of relying on self-evaluation, you might ask a friend or even a waiter or bartender for input. However, this approach is risky as well because others can only guess at how intoxicated you might be based on outward signs. It is possible for an individual to display negligible symptoms, yet still be over the legal limit in terms of blood alcohol content.
For a more reliable assessment, consider using a BAC (blood alcohol content) calculator app. Many of these applications are available at no or low cost and may be downloaded to your phone or accessed via a web browser. The most rudimentary versions ask you to input your weight, gender, the number of drinks you’ve consumed, and how long you’ve been drinking, and then the app calculates your BAC. Some ask for the state in which you’re located and tell you whether you’re over the legal limit for that jurisdiction.
More sophisticated versions save your basic information (gender, age, height, weight) in a personalized profile and allow you to track consumption and intoxication over time. These calculators compare your alcohol intake to your metabolic removal rate and compute your BAC real time, providing continual updates. Most provide features to help manage your consumption as well. For example, some allow you to set a target BAC and sound an alarm when you’ve reached it. Others will provide an estimate of how long you need to wait without drinking before your BAC returns to a legal level. Some apps even allow you to set up multiple profiles so that you can track the BAC of your companions.
The sophistication and ease of use of these applications improves every day, with particular attention being paid to the user interface, making use of the app as easy and unobtrusive as possible. An innovation in one app allows the user to input a drink simply by clicking on a picture illustrating the beverage. Of course, different people metabolize alcohol at different rates, so even the apps carry a degree of uncertainty. To be safe, don’t try to manage your consumption right at the edge of your state’s legal limit. Instead, stay well under and keep yourself hydrated by drinking water or other non-alcoholic beverages.
For Your Companions
Responsible drinking doesn’t stop with oneself. We also have a responsibility to the friends, family, colleagues, and companions with whom we imbibe. Following are suggestions for helping keep everyone safe.
- Volunteer to be the non-drinking, designated driver at your next event or outing.
- Throw a safe party.
- Ask guests to designate a non-drinking driver before arriving to ensure everyone gets back home safely. As they arrive, ask everyone to identify their designated driver and give that person a celebratory badge to wear so that others don’t offer them drinks all evening. You might even offer a small gift in token of appreciation.
- Serve mocktails and other non-alcoholic beverages.
- Offer alternate transportation or accommodations for guests who have been drinking.
Prevent another individual from driving drunk
We’ve all been in a situation where we’re sober, but someone else has consumed too much alcohol and intends to drive themselves home. The easiest way to prevent this scenario is to agree on a non-drinking, designated driver before anyone begins to drink; but if you find yourself in a situation where an impaired person is about to get behind the wheel, consider the following.
- Be as non-confrontational as possible.
- Suggest alternate ways of getting to their destination—a cab, a sober driver, public transportation.
- Remember that the individual to whom you are speaking is impaired. Talk slowly and explain things more fully than you would if speaking to a sober person.
- Explain that you don’t want them to drive because you care and you don’t want them to hurt themselves or others.
- Suggest they sleep over.
- Enlist a friend to help you or to act as moral support. It’s more difficult for the inebriated individual to say “no” to two (or three or four) people than one.
- If possible, get the person’s keys. This gives you leverage in the situation.
- If all else fails, call law enforcement. It’s better to have a friend arrested than injured or killed.
Even if you and your companions are careful never to drink and drive, others will not behave so responsibly. You face danger on the roads from drunk drivers. Learn to recognize signs of possible intoxication in other drivers and keep yourself safe.
How to Spot a Drunk Driver
Keeping yourself and your family safe on the roads requires vigilance. Look for these signs as possible signals of intoxication in other motorists.
- Quick acceleration or deceleration
- Weaving or zig-zagging
- Turning abruptly or illegally
- Stopping or braking without cause
- Driving anywhere other than on a road designated for vehicles
- Nearly striking an object, curb, or vehicle
- Drifting in and out of traffic lanes, or straddling the lane markers
- Giving signals inconsistent with driving actions (e.g., turning without signaling)
- Slow response to traffic signals (e.g., sudden stop or delayed start at traffic light)
- Driving with headlights off at night
- Driving slower than 10 mph below the speed limit
- Driving into opposing traffic on the wrong side of the road
What To Do if You See a Drunk Driver
Drunk drivers get on the roads, endangering us and our friends and loved ones. If you see signs which lead you to believe another car is being driven by someone under the influence, follow these suggestions.
- Stay as far away from the other vehicle as possible. Do not try to pass unless you can maintain a significant distance while doing so.
- Do not attempt to signal the driver. His or her communication skills are already impaired. You will not be able to communicate with them from your car while you both attempt to drive.
- If you can do so without compromising your own safety, note the license plate number and vehicle make, model and color.
- Pull over and call 911. Give the operator the location of the vehicle—road, cross street, exit number, direction in which the vehicle is traveling—and as complete a description of the vehicle as possible. Describe the manner in which the vehicle is being driven.
- Leave the rest up to law enforcement.
V. Blood Alcohol Content
The law has established a threshold for what they consider safe versus unsafe driving based on alcohol content in the bloodstream. The legal threshold is 0.08 percent blood alcohol content (BAC), and consequently individuals may be charged with DUI/OVI if BAC exceeds 0.08. This page will examine how alcohol enters and impacts the body. It will also explain how to calculate BAC. By monitoring one’s own BAC, individuals may maintain an accurate assessment of their level of alcohol impairment and consequently their ability to drive safely.
Alcohol reaches the brain within seconds of entering the bloodstream. There it has a depressant effect resulting in:
- Diminished visual and hearing capabilities (blurred, double or swimming vision; reduced ability to recognize certain audio signals)
- Reduced muscular coordination (clumsiness)
- Deterioration of judgment and self-control (euphoria and loss of inhibitions)
The extent of impairment varies from person to person. According to the National Highway Traffic Safety Administration, persons with BAC levels of .08 exhibit delayed reactions, impairment in attention, tracking and comprehension.
The amount of alcohol in the bloodstream at any given time is a function of how much alcohol the person consumes (which we’ll discuss below) and on the following:
- How fast alcohol is absorbed into the bloodstream.
- How fast it’s eliminated from the body.
Absorption into the Bloodstream
When someone takes a drink, the alcohol is absorbed into the blood through the mucous lining of the entire gastrointestinal tract—the mouth, the esophagus, the stomach, and the small intestine—and it is absorbed faster as the drink moves down the tract. Food, water, and citrus juices in the stomach can slow the absorption of alcohol in the stomach. Interestingly, the presence of carbonation in a drink, as in champagne, can speed the absorption of alcohol. For the average person, a general rule of thumb is that about 60 percent of the alcohol consumed at a given time will have been absorbed into the bloodstream within half an hour.
This number will climb to 90 percent after an hour, and essentially all the alcohol will have been absorbed within 90 minutes. This is true for an average individual with an average food load in the stomach who is drinking average drinks, however the rate at which alcohol enters a person’s blood will vary dramatically depending on the quantity of alcohol taken in, the concentration of alcohol in the drink, the rate of drinking, and the nature and amount of diluting material already in the stomach.
Elimination From the Body
Alcohol leaves the body in two ways:
- Oxidation, or metabolism
Ninety to ninety-five percent of consumed alcohol is oxidized, or metabolized, mostly in the liver, to form water and carbon dioxide (a gas that dissolves in the blood, goes to your lungs, and is exhaled).
The rate of oxidation is pretty much the same over time, but it varies from person to person depending on how well the individual’s liver functions. People who drink regularly burn alcohol faster than casual drinkers. Chronic alcoholics burn it even faster.
The remaining 5 to 10 percent of the alcohol is excreted or eliminated without any chemical change. It leaves the body via sweat or urine, and in the breath as a gas (which is what the breath test, or breathalyzer, measures).
Calculating Individual Limits
How long does this two-pronged alcohol-elimination process take? After about 40 minutes have passed, the average person’s body will begin eliminating alcohol from the bloodstream at a rate of about 0.01 percent for each additional 40 minutes.
At this point, you may be wondering how much you can drink before it is no longer safe for you to drive. The following calculation will help you determine whether or not you should drive. Always remember that if you feel impaired, no matter the results of this or any calculation, you should not get behind the wheel of an automobile.
- Divide the number 3.8 by your body weight in pounds. You should get a number between 0.015 and 0.040. This is your own personal “blood-alcohol-maximum-per-drink” number and it represents the percentage by which your BAC will increase with each drink you take.
- For purposes of this calculation, a regular drink is 12 ounces (regular-sized bottle) of 4 percent alcohol beer, four ounces (small wine glass) of 12 percent alcohol wine, or a one-ounce (shot glass) of 100-proof liquor. Most bar cocktails contain this amount of alcohol.
- Microbrewery beer, malt liquor, pint bottles of beer, large (six-ounce) wine glasses, fortified wines (20 percent alcohol), and stiff or large mixed drinks will increase BAC 1.5 times as much as regular drinks.
As an example, a person weighing only 100 pounds would have a blood-alcohol-maximum-per-drink of .038, meaning her BAC could be as much as 0.038 percent after just one drink. That would rise to 0.076 percent from two drinks, and three drinks could put her over the 0.08 percent legal BAC limit, especially if the drinks were consumed quickly on an empty stomach.
By contrast, a person weighing 240 pounds would have a blood-alcohol maximum per drink of .016 percent. To reach the 0.08 percent BAC legal limit, this person would need to consume six drinks in an hour.
VI. Alcoholism and Rehabilitation
In early 2006, an Ohio man killed two Hiram College students in an alcohol-related accident. Prior to the accident, he had accumulated twelve DUI offenses over a ten-year period. He was driving his girlfriend’s truck without a license when he struck the vehicle carrying the students. Sadly, there are many stories like this. According to the National Institute on Drug Abuse, in 2008 an estimated 31 million people reported driving under the influence of alcohol at least once in the prior year. For many of these people, alcohol dependency played a role in their risky behavior. Harvard Medical School conducted a study which suggests the problem of alcoholic illness is far more pervasive than one might think.
The study revealed that approximately one in 16 adults has severe problems with drinking and that millions more are engaged in what experts consider risky drinking. A DUI charge can be a sign of an underlying alcohol problem requiring treatment, and repeat DUI offenses are an almost certain indicator. Alcoholism is a disease, formally recognized by the American Medical Association in 1958. Unlike most diseases, alcoholism cannot be cured by surgery or medication. Unlike most diseases, alcoholism puts both the sufferer of the disease and everyone around that person in danger. And unlike most diseases, alcoholism turns a driver into a killer and a car into a deadly weapon.
Multiple DUI offenses are an almost certain signal of alcoholism. According to the U.S. Department of Health and Human Services, other signs and symptoms include:
- Craving for, strong need for, or continued use of alcohol despite the negative consequences
- A greater tolerance for alcohol as evidenced by the need for increased amounts of the substance in order to feel the buzz
- Loss of control over the amount of alcohol used or the time and place of use
- Physical dependence or withdrawal symptoms when alcohol use stops
Tougher laws serve to punish drunk drivers but will not treat alcoholism. The law is awakening to this reality, and new policies in several states make it mandatory for offenders to undergo an assessment interview with a counselor before it is decided what steps must be completed in order to reinstate a license. The assessment interview is meant to determine the kind of relationship an offender has with alcohol. Based on the interview, a counselor may order the offender to attend Alcoholics Anonymous meetings—as few as three or four meetings or, in more serious cases, 90 meetings in 90 days.
An offender may also be ordered into a residential treatment facility, a detoxification program, medical treatment, or one of a variety of outpatient therapeutic programs. Judges have also begun ordering offenders to cease all alcohol consumption and to wear SCRAM (secure continuous remote alcohol monitoring) bracelets as a condition for release from custody and reinstatement of limited driving privileges.
The SCRAM device is an ankle bracelet that gathers data at the surface of the skin and can detect the presence of alcohol in the wearer’s body. The device ensures that a judge will know if the offender drinks and can apply consequences. The kind of accountability afforded by this sort of continual monitoring is often what it takes to keep the offender in treatment.
The Rehabilitation Route
Alcoholism is not a disease that can be cured, but the alcoholic can learn to manage the disease and its associated cravings and consequently eliminate the destructive behaviors engendered by the illness. This process of awareness-building and behavior modification is referred to as rehabilitation.
A rehab program can help a DUI defendant deal with his or her substance abuse problem, improving health and quality of life. Additionally, in many states, if a DUI offender agrees to rehab, he or she can also decrease or eliminate the legal consequences of a DUI charge such as jail time, fines, and driver’s license suspension. Though DUI laws vary by state, voluntary rehabilitation may yield any of the following outcomes:
- Diversion. In some states, certain defendants have the opportunity to “divert” their case out of the criminal court system (and avoid a criminal record) by successfully completing a rehabilitation program. These programs are usually available to first-time offenders charged with non-violent DUI crimes only. If the defendant fails to complete the program and/or commits another offense, he or she will likely be prosecuted for the original DUI charge in addition to subsequent offenses.
- Reduction of jail time and fines. Many states allow judges the discretion to credit inpatient rehabilitation against jail time and/or towards a fine. Judges often look favorably upon defendants who voluntarily enter a rehabilitation program in an attempt to overcome their disease.
- Reinstatement of driver’s license. Even in states where the courts do not have mandatory education and/or treatment, the Department of Motor Vehicles often requires education and/or treatment programs as a condition for reinstatement of an offender’s driver’s license.
A defendant who seeks treatment voluntarily is more likely to find a program and facility well matched to his or her needs and in turn, has a greater likelihood of success in recovery. Furthermore, voluntary treatment demonstrates to the courts a vested interest in recovery. If a defendant does not seek treatment prior to conviction, he or she will be required to accept the court’s recommended treatment program.
Therapies for Treating Alcoholism
In 2013, 22.7 million persons needed treatment for an illicit drug or alcohol problem, according to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health. According to the National Institute on Drug Abuse, combining medication with behavioral therapy is the best way to ensure success for most patients.
Medications can help patients manage the symptoms of withdrawal (nausea, shakes, and sweating), remain in a treatment regimen (by reducing cravings and allowing the patient to focus), and prevent relapse (by managing triggers).
Some popular behavioral treatment philosophies include:
- Cognitive Behavioral Therapy (CBT). CBT is based on the idea that the way we think causes our feelings and actions, not external things like people, situations, and events. CBT sessions are usually more intense, briefer, and fewer in number than other types of therapy.
- Motivational Enhancement Therapy (MET). MET is based on the idea that the responsibility and capacity for change comes from the patient. The therapist helps evoke the patient’s motivation and commitment for change and assists the patient in developing his or her own goals. MET is conducted individually (though family members may be present) in an inpatient or outpatient setting.
- Twelve-Step Self-Help Programs. Self-help groups are frequently sought by those struggling with alcohol abuse. Alcoholics Anonymous (AA), one of the most well-known self-help programs, outlines 12 steps alcoholics should achieve during their recovery. Participation in self-help programs can occur before, during, and/or after rehabilitation.
In-Patient or Residential Rehabilitation
Therapies for treating alcoholism may be administered in any number of venues; however, the setting often chosen by the courts in DUI cases is that of in-patient or full-time residential rehabilitation facilities. For the severely dependent alcoholic, this type of program is generally the only viable option because individuals are unable to manage the symptoms of withdrawal or summon the discipline for behavioral change on their own. In-patient or residential rehabilitation generally lasts 21 to 28 days, though the stay may be longer in some cases.
Patients requiring detox may need to enter rehab initially at a medical rehab facility or rehab hospital where the physical symptoms of withdrawal—convulsions, vomiting, sweating—can be managed with medication and the patient can be physically stabilized under medical supervision before moving on to the next phase of rehabilitation and treatment. Some additional reasons DUI defendants might go to a rehab facility include:
- Problems with both alcohol AND drug abuse
- Multiple DUI offenses
- Outpatient programs such as Alcoholics Anonymous (AA) have been ineffective
- Because the court orders it in order for the judge to feel confident the defendant will actually stay in a treatment regimen
Often, even after a stint in a residential facility, the individual will need to continue to receive treatment and support on an outpatient basis. Residential programs help the alcoholic build awareness of the triggers for alcohol consumption and their underlying causes and begin to treat the underlying emotional drivers. Residential programs also help the patient begin the process of developing structured routines to help avoid the triggers for drinking; however, outside the walls of the rehab facility, it is easy for the alcoholic to fall back into old patterns. Some patients choose to transition from residential rehab to a supportive living environment like a sober living home.
Many will also need to continue behavioral therapies in group or individual therapy sessions. Most recovering alcoholics also need to associate with a group like Alcoholics Anonymous, which provides a sober accountability partner who is further down the path of recovery as well as group sessions within which the patient can receive support from others who face the same challenges. According to the Pacific Institute for Research and Evaluation, when searching for a quality drug and alcohol rehabilitation center it is important to consider the extent to which the facility offers the following:
- Creation of a treatment plan tailored to each client’s individual needs with specific, measurable goals
- Provision for family involvement
- Provision for aftercare
- Willingness to report back to the court (or probation official) to help enforce compliance with an order for treatment
- Access to medical backup to ensure safe detoxification and healthcare, if required
- Sensitivity to ethnic, gender, and other differences that might affect treatment effectiveness
- Bilingual capability, if needed