I'd like to thank the House of Commons Standing Committee on Justice and Human Rights for this invitation to contribute my perspective to your comprehensive review of matters related to impaired driving.
I'm a clinical psychologist and behavioural scientist affiliated withe the Douglas Hospital Research Centre in Montreal at McGill University. My research program into impaired driving, DUI, is focused on the why and the wherefore of recidivism--that is, what are the characteristics that contribute to DUI recidivism and what does that knowledge tell us about how to prevent it?
The focus of my brief is on repeat offenders who are associated with the greatest risk and burden to health and society, some of the most significant findings we have collected in our work, and what they may mean and how we address a problem in the future. Frequently when people discuss DUI recidivism and what to do about it, it often is from very specific perspectives with implicit or explicit assumptions about who recidivists are and what they're like.
First off, measures such as lowering the legal limit for blood alcohol and increasing fines and other deterrents as well as providing remediation to treat problem drinking seem reasonable to reduce the incidents of DUI in general. However, such measures have proven of more limited value in addressing the problem of recidivists, who, by definition, are impervious to these measures. Our work has attempted to find out why the usual deterrents and remedial measures do not work. What we have found is that recidivism is associated with several individual characteristics that go beyond the severity of alcohol abuse or dependence or even other individual characteristics often linked to recidivism, such as criminality, anti-social tendencies, and so on.
We have evidence that risk of DUI recidivism is linked to important neuro-cognitive problems, particularly in domains influencing memory, learning, and planning. We know that problems in these areas reduce the effectiveness of many kinds of psycho-social interventions for all sorts of behavioural problems. For example, if some offenders have difficulty remembering plans they made to avoid a drinking-driving occasion, not to mention remembering them when intoxicated, it is obvious that even the best laid plans to change drink-driving will not be very successful.
This is a fairly novel finding, although it makes intuitive sense if we remember that alcohol can be quite toxic for the brain, especially if one drinks early on in life, when the brain is still developing, for example binge drinking in adolescence, or if one has a genetic susceptibility to drink a lot, and again, early on. In fact, recidivists do tend to report earlier problem drinking than non-recidivists. That is not to say that all recidivists have brain damage, but many more of them do compared to what we might expect in the general population.
Another finding is that recidivists, more than those who are not likely to be so, have specific hormonal responses to stress that suggest they may not respond to fear-provoking situations and risk or danger in the same way as others. A situation that would provoke an unpleasant emotional reaction such as fear and foreboding in us, such as the threat of being arrested a second time for a DUI offence, does not have the same emotional impact on these individuals. This may explain why for some offenders our strategies of deterrence, that is, the fear of arrest, conviction, fines, and even prison, just do not have the desired dissuasive impact, no matter how tough they are.
We also know that many individuals after a DUI conviction do not participate in the remedial measures required for re-licensing in a timely manner. And the numbers are staggering. About 50% in Quebec delay for significant periods of time their re-licensing procedures and up to 80% in other North American jurisdictions. Our research indicates that these individuals share some common reasons for not doing so. One main reason is that reacquiring their licence is simply too costly. By the way, these individuals are also economically more disadvantaged, so their perceptions of costliness seem to make sense. Another is that they have made other transportation arrangements, making paying all the costs and changing their behaviour, especially drinking, unnecessary. One problem we have found is that some who do not reacquire their licence continue to drive unlicensed. That means that they are driving and have not participated in the remedial intervention programs that we have developed to help them deal with alcohol problems.
It is not surprising, then, that our data indicate that while these individuals drive less than those who reacquire their licence, when they do drive, the risk that they are impaired while they're driving is much higher. So here's the paradox: the individuals who most need to have help in resolving a drink-driving problem and pose the greatest DUI risk are the very ones who are least capable of accessing the remedial help they need.
What do these findings suggest to us concerning what can be done to help reduce the risk of DUI recidivism? First, measures that are effective in reducing recidivism in some may not be effective in others. More specifically, if an offender has difficulty remembering his plans to avoid a drink-driving occasion, if he has difficulty even making feasible plans, clearly this will alter how we might envision helping such an individual to reduce the risks they pose. Furthermore, if an offender has a reduced reaction to fear and stress-provoking experiences, the threat of future arrests, punishments, and so on are not winning strategies and other approaches need to be considered.
Finally, if participation in remedial programs to reacquire a licence remain costly, we will tend to dissuade those individuals who really need these services from participating and getting back their licence. One might argue that keeping some of these individuals off the road by making it difficult for them to reacquire a licence is a good thing. Maybe so, but clearly in a rural area, where alternative transportation arrangements are virtually non-existent and the risk of arrest is low, it seems almost inevitable that in order to work, play, or socialize, driving unlicensed will be considered a viable solution for some offenders, rather than dealing with the alternatives--no work, no play, no socializing.
Being able to figure out who's who, and then what precisely they need in the way of remediation, becomes essential. Currently, our DUI assessments are quite limited in scope, focusing mainly on alcohol and drug use. Moreover, the importance of a lot of the information collected, even biological markers of alcohol use, to predict recidivism is quite limited. It's about 50-50. In fact, the accuracy of the vast majority of evaluation protocols currently being employed have not been objectively evaluated.
Concerning intervention, the impact of participation in remedial counselling programs is modest, estimated at about a 7% to 9% improvement in reducing DUI recidivism. Interlock seems to work better, for as long as they are installed and for those who actually sign on to use them, which I understand is about 10%.
Given that these statistics are based only upon those who are involved in remedial programs to begin with, and it looks like the majority of recidivists do not engage in these protocols, we are not doing as great as we might like to think. But as modest as the benefits of these programs are, they are the best we have.
What are some of the solutions suggested by our work? First, we need to remove all obstacles to participation in our remedial strategies. Intervention programs, interlock devices--whatever--should be made as available as possible if we believe them to be effective and we want as many people as possible to benefit from their use. We may even consider decoupling any notion of punishment or deterrence from measures that could help people deal with their problems. Even providing incentives for them to participate in remedial measures should be part of the debate.
Second--and this comes from a researcher--we need to invest in research in order to address the following three priorities: first, objectively evaluate the effectiveness of current assessment protocols; second, develop new approaches to assessment that are more effective in appraising risky characteristics associated with recidivism; and third, develop new and more varied approaches to intervention that take into account the fact that recidivists, the toughest ones, are not all the same and may not respond to interventions that are effective with people more like those in this room.
Driving research, and DUI research specifically, is not well funded by public funding agencies relative to other health concerns. It should be, because the burden on health and society is staggering. Car accidents, about 40% of which involve alcohol, are the source of the greatest morbidity in children and young adults.
Finally, and at the risk of complicating life, we need to acknowledge that recidivists are very different one from the other, and that any one approach to reducing recidivism is not likely to be adequate. But as we see in the alcoholism and other problem behaviour areas, a shotgun approach—throw everything at them—is not very effective and not particularly cost-efficient either. It seems likely that in looking to the future, we will have to be prepared to better tailor our strategies to the individual characteristics of offenders.
Thank you.