Driving Under the Influence of Alcohol

While the rate of alcohol-related traffic fatalities declined nationally over the past two decades, California's rate began to rise again in 2011. This Perspective considers whether California could do more to reduce driving under the influence (DUI) and other threats to public health and safety imposed by repeat DUI offenders. California's current approach to addressing DUIs largely focuses on reducing the probability that individuals drive while impaired. In this Perspective, we argue that future approaches will also need to better target the problem drinking that underlies impaired driving and other negative outcomes. We consider strategies currently in use statewide and in some California counties, as well as in other states. Many options are discussed, including ignition interlock devices, DUI courts, the 24/7 Sobriety program, and substance use treatment, including pharmacotherapy, for those with an alcohol use disorder. At this point, there is insufficient evidence about which types of programs work best for which individuals. Research is needed to assess the effectiveness and cost-effectiveness of these new strategies for addressing repeat DUI offenders.