Association of an Alcohol Abstinence Program With Mortality in Individuals Arrested for Driving While Alcohol Impaired

Alcohol is the third-leading cause of preventable death in the US, with alcohol-impaired driving alone claiming 11,654 lives in 2020 — a 14% increase over the previous year. To address this problem, some jurisdictions are using 24/7 sobriety programs, which combine alcohol abstinence orders with frequent alcohol testing (eg, twice-daily breathalyzers, monitoring bracelets) and swift, certain, and moderate sanctions for noncompliance (typically 1 to 2 nights in jail) to reduce alcohol consumption among those arrested or convicted for alcohol-involved offenses. This article presents individual-level analyses which suggest that among those arrested for driving under the influence in South Dakota, participation in 24/7 Sobriety reduces risk of death during study period—on the order of 50%. To our knowledge, this is the first evidence from individual-level data that such programs may improve health outcomes.