Unique alcohol avoidance program is associated with lower death rates

A statewide alcohol-monitoring program in South Dakota that requires people arrested for drunk driving and other alcohol-involved offenses to be tested frequently for alcohol use can reduce the likelihood that participants die during the years after their involvement with the program, according to a new RAND Corporation study.

Analyzing results from the 24/7 Sobriety Program, researchers found that those arrested for drunk driving who participated in 24/7 Sobriety had on the order of a 50% lower risk of dying during the study period compared to those arrested for drunk driving who did not participate in the program.

The results are published in the latest edition of the journal JAMA Psychiatry.

"These findings add a public health dimension to the growing evidence that the 24/7 approach improves public safety by reducing rearrest," said Nancy Nicosia, the study's lead author and a senior economist at RAND, a nonprofit research organization. "We believe this is the first evidence that such programs may also improve health outcomes for those who are enrolled."

Alcohol is the third-leading cause of preventable death in the U.S. with alcohol-impaired driving alone claiming 11,654 lives in 2020—a 14% increase over the previous year.

The South Dakota 24/7 program is a public safety effort largely focused on those who are repeatedly arrested for alcohol-involved offenses. The program imposes very frequent alcohol testing along with swift but modest sanctions for those testing positive or missing a test—typically a night or two in jail.

Past RAND studies have shown that the 24/7 program in South Dakota lowers the likelihood that participants will be rearrested or have probation revoked, as well as reducing county-level repeat DUI arrests and domestic violence arrests.

"We have also found evidence that 24/7 Sobriety improves impaired driving outcomes in other states," said Beau Kilmer, a co-author on the study and codirector of the RAND Drug Policy Research Center.

For the new study, researchers analyzed criminal history and mortality data for individuals arrested for driving under the influence of alcohol in South Dakota during 2004 to 2011. The sample included 11,827 people who participated in the 24/7 program and 48,834 nonparticipants.

Researchers used several statistical approaches to compare death rates between the two groups, with each adjusting for any differences between participants and nonparticipants. All of the methods showed a lower likelihood of death among those who participated in the 24/7 program as compared to those who did not.

Support for the study was provided by the National Institute on Alcohol Abuse and Alcoholism. Other authors of the study are Greg Midgette of the University of Maryland and Marika Suttorp-Booth of RAND.

Since 1989, the RAND Drug Policy Research Center has conducted research to help policymakers in the United States and throughout the world address issues involving alcohol and other drugs. In doing so, the center brings an objective and data-driven perspective to an often emotional and fractious policy arena.