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Assessment and Treatment of DWI Offenders in Maryland 1995-2003 : Current Findings. Prepared by: Amelia M. Arria, Ph.D. Center for Substance Abuse Research (CESAR) University of Maryland [email protected] ; 301-405-9795 Submitted to: Peter F. Luongo, Ph.D.

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Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

Assessment and Treatment of DWI Offenders in Maryland 1995-2003: Current Findings

Prepared by:

Amelia M. Arria, Ph.D.

Center for Substance Abuse Research (CESAR)

University of Maryland

[email protected]; 301-405-9795

Submitted to:

Peter F. Luongo, Ph.D.

Director, Maryland Alcohol and Drug Abuse Administration

Acknowledgements: Kevin O’Grady, Ph.D. , Peter Smith, B.S., Nadine Connell, M.A., William T. Rusinko, M.A., Vickie Kaneko,

Michael Wagner, Ph.D., and Eric D. Wish, Ph.D.

This project was funded by grant #50499 to CESAR from the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation.


Maryland statistics

Maryland Statistics

  • Total Fatalities per 100,000 Drivers (% alcohol-related)

    Average U.S.: 14.7 (40% alcohol-related)

    Maryland: 18.3 (43% alcohol-related)

  • Total Persons Killed in Alcohol-related Crashes

    Total U.S: 17,013 people

    Maryland: 281 (roughly 5 people/week)

August 11, 2005


Background

Background

  • Assessment of DWI offenders in Maryland is not well characterized.

  • Anecdotally it was thought that many DWI offenders, even if assessed

    as “problem drinkers” and ordered to treatment, do not show up to receive

    treatment services in Maryland.

  • Little is known of the treatment experiences of DWI offenders in Maryland.

  • This study was a first step in examining the effectiveness of treatment for

    DWI offenders.

  • From earlier studies in Maryland, we know that substance abuse treatment

    completion is associated with increased employment and reduced arrest.

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

DWI arrest

?

?

Problem Drinker

Enters Treatment

Re-assessed

DWI

assessment

?

Does Not Enter Treatment

Is not

Re-assessed

Social Drinker

What questions did this study try to answer?

Note on data linking procedures: DWI assessment data was obtained from ADAA for individuals assessed during the period of 1995-2003. Only individuals who had one assessment for their offense were included. DWI data was merged with the ADAA database on individuals receiving substance abuse treatment in Maryland from a certified program.

August 11, 2005


What do we mean by re assessment

What do we mean by re-assessment?

  • In this study, we use

  • assessment as a proxy

  • for arrest and re-arrest for

  • a DWI offense.

  • We do not know the exact

  • percentage of DWI offenders

  • who receive an assessment,

  • an estimate is 60-70%.

  • Our measure of re-assessment

  • misses some people who were

  • re-arrested for DWI but not

  • re-assessed.

All DWI arrests

DWI

Assessments

August 11, 2005


First stage results problem determination and treatment entry

First Stage Results: Problem Determination and Treatment Entry

n = 50,859 65%

Problem Drinker

DWI assessment

1995-2003

Social Drinker

n = 77,845

n = 26,986

35%

August 11, 2005


How much variability exists in the assessment process of dwi arrestees in maryland

How much variability exists in the assessmentprocess of DWI arrestees in Maryland?

  • From interviews conducted with 161 assessment centers, the method for making a “problem drinker” determination varied widely:

    less than 10% of centers used standardized diagnostic criteria;

    40% used the Addiction Severity Index

    75% used the Michigan Alcoholism Screening Test (MAST),

    a brief assessment tool to assess alcoholism

    47% used two of these assessment methods

  • The average length of time estimated to conduct an assessment varied from 15 minutes to over 90 minutes.

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

County-level variation in assessing individuals as

“Problem Drinkers”

88%

49%

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

Social

Drinkers,

29%

Problem

Drinkers,

71%

Difference between Public and Private Assessment Centers on the proportion of DWI arrestees assessed as “Problem Drinkers”

Public Assessment

August 11, 2005


Problem drinker determination and income level

Problem Drinker Determination and Income Level

Individuals with lower incomes are significantly more likely to be assessed as

Problem Drinkers than individuals with higher incomes

August 11, 2005


Problem drinker determination and bac level

Problem Drinker Determination and BAC Level

Problem Drinkers are significantly more likely to have BAC levels above 0.14 than

Social Drinkers, and the average BAC is 0.15 and 0.12, respectively.

August 11, 2005


Problem determination and treatment entry

Problem Determination and Treatment Entry

n = 50,859 65%

Enters Treatment

50%

Problem Drinker

13%

DWI assessment

1995-2003

Social Drinker

50%

n = 77,845

n = 26,986

35%

87%

Does Not Enter Treatment

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

County-level variation in the proportion of

Problem Drinkers entering treatment

78%

38%

August 11, 2005


Second stage results re assessment

Second Stage Results: re-assessment

DWI assessment records from 1995-1999

N = 43,589

“Problem Drinkers”

Social Drinkers

n = 29,019

65.8%

n = 14,570

34.2%

Entered Treatment

10.2%

re-assessed

n = 13,072

46.7%

n = 1595

10.9%

7.1%

re-assessed

Did not Enter Treatment

10.2%

re-assessed

17.8%

re-assessed

n = 15,947

56.9%

n = 12,975

89.1%

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

Impact of Treatment on Re-assessment1

1re-assessment is measured by a repeat appearance in the assessment database, and is very likely an underestimation of true repeat offending since not all offenders receive assessments.

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

SUMMARY: Findings that have Potential Policy Implications

  • Assessment Process for DWI offenders is not highly standardized.

  • Problem Drinker Determination varies by county, income level and assessment center funding status.

  • Over half of problem drinkers do not enter treatment and the proportion of individuals entering treatment varies by county.

  • Treatment completion was significantly associated with a reduced likelihood of re-assessment.

  • Administrative data is useful in creating ongoing, sustainable outcomes monitoring systems.

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

Recommendations for System Change

  • Standardize assessment process to include diagnostic instruments

  • Streamline assessment process to eliminate the time gap between

  • assessment and treatment

  • Eliminate the distinction between problem and social drinkers –

  • rather, base the need for treatment on a comprehensive substance

  • abuse assessment and match individuals to appropriate levels of

  • treatment

  • Put into place tighter monitoring systems for the assessment and

  • treatment entry process to ensure timely entry into services

August 11, 2005


Assessment and treatment of dwi offenders in maryland 1995 2003 current findings

Recommendations for Future Studies

  • Compare problem and social drinkers who were re-assessed on

  • what problem determination was given the second time.

  • Investigate reasons for county-level differences in problem determination and

  • treatment entry for DWI offenders.

  • Understand more about the characteristics of assessment centers, and

  • the process they use to make problem determinations.

  • Estimate the likelihood of treatment for individuals who are re-assessed

  • multiple times.

  • Obtain arrest records to more clearly understand re-arrest rather than

  • only re-assessment.

August 11, 2005


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