Responses to the Problem of Drug-Impaired Driving

Your analysis of your local problem should give you a better understanding of the factors contributing to it. Once you have analyzed your local problem and established a baseline for measuring effectiveness, you should consider possible responses for addressing the problem.

The following response strategies provide a foundation of ideas for addressing your particular problem. These strategies are drawn from a variety of research studies, government initiatives and police reports. Several of these strategies may apply to your community problem.

It is critical that you tailor responses to local circumstances and that you can justify each response on the basis of reliable analysis of accurate data. In most cases, an effective strategy will involve implementing several different responses. Law enforcement responses alone are seldom effective in reducing or solving the problem.

Do not limit yourself to considering what police can do: carefully consider whether others in your community share responsibility for the problem and can help police better respond to it. The responsibility of responding, in some cases, may need to be shifted toward those who have the capacity to implement more effective responses. (For more detailed information on shifting and sharing responsibility, see Response Guide No. 3, Shifting and Sharing Responsibility for Public Safety Problems).

For further information on managing the implementation of response strategies, see Problem-Solving Tools Guide No. 7, Implementing Responses to Problems. 

General Considerations for an Effective Response Strategy

Generally, any enforcement, intervention or prevention programs that attempt to minimize or delay onset of illicit substance use can also help reduce incidents of drug-impaired driving.†

In addressing drug-impaired driving, you would do well to begin by examining your local strategies for responding to drunk driving and considering using parts of that framework as a starting point for responding to drug-impaired driving.‡ The lessons we have learned about drunk driving can directly inform many of our responses to drug-impaired driving. For example, first-time drunk-driving offenders can likely be influenced and persuaded to desist, but repeat offenders' behavior is far more difficult to change, and they are at increased risk of continued offending.34 Therefore, you should consider adopting different sets of responses that address first-time drug-impaired drivers and repeat offenders.35 

† For further information on addressing the broader issues related to drug use, readers are encouraged to review the POP Guides on Drug Dealing in Open-Air Drug Markets (No.31), Drug Dealing in Privately Owned Apartment Complexes (No.4), Clandestine Methamphetamine Labs (No.16), Rave Parties (No.14), and Prescription Drug Fraud and Abuse (No.24).

‡ See Problem-Specific Guide No. 36, Drunk Driving for further information. 

Specific Responses to Reduce Drug-Impaired Driving

Legal and Administrative Responses

1. Implementing per se (also known as "zero-tolerance") laws. Many jurisdictions have implemented per se laws in which a specified level of an illicit drug found in the body of a driver is, in and of itself, defined as an offense. Within the context of illegal drugs, zero-tolerance laws include those that set the limit of illicit drugs at the minimal drug detection level. Therefore, under zero-tolerance laws, it may not be necessary to prove that drivers were actually impaired but only to demonstrate that they had a detectable amount of an illegal drug in their body while driving.36 Other states, and some scientists, have an interest in identifying reasonable detection levels that suggest impairment by some substances (including marijuana).37 Nevertheless, zero-tolerance laws, while not necessarily improving the enforcement of the laws, appear to improve prosecution rates in some states.38 Broader adoption of zero-tolerance laws has been carefully studied and recommended.39 However, actual enforcement of zero-tolerance laws may be challenging, because police officers may still need to use the premise of perceived impairment as the justification for a traffic stop. Therefore, per se and zero-tolerance laws may ultimately focus attention primarily on drivers who are substantially impaired, as opposed to the larger population of drivers who have illicit substances in their bodies.40 Furthermore, per se and zero-tolerance laws may not include drug-impaired drivers who are using prescription or over-the-counter medications (because possession, as determined by a laboratory or field test of those drugs, may not be illegal, in and of itself).

2. Developing drug-impaired driver courts. Drug-impaired driver courts, generally modeled on drug courts, have been developed and implemented in South Dakota and in Erie/Niagara, New York.41 These specialized courts have been used to respond to first-time offenders, but they mostly target high-risk and repeat offenders and are focused on managing substance abuse problems, one of which is drug-impaired driving. Because initial evaluations and reviews of these kinds of intervention efforts are promising, like the evaluation and review of drug court effectiveness overall, much broader adoption of drug-impaired driver courts should be encouraged, given the cost of trying offenders in drug courts compared with the cost of their incarceration,42 especially for serious recidivists.43

3. Implementing or improving on-site, point-of-contact (field) drug-testing devices and protocols. A number of drug-screening devices are available for use in the field. One initial evaluation suggested that Los Angeles police officers were quite effective at field testing, although there was some room for improvement.44 However, a larger study that examined a wide variety of testing methods across a broad array of substances suggested that no devices can yet be recommended.45 As a result, continued development of drug-testing devices that ensure accuracy, reliability and usability is necessary.

4. Standardizing lab- and field-testing protocols. Uniformity in lab and field drug-testing standards and protocols is also important. Professional organizations such as the American Board of Forensic Toxicology (ABFT), the American Society of Crime Laboratory Directors/ Laboratory Accreditation Board (ASLD/LAB) and other similar entities should continue to take the lead in aligning laboratory standards internationally and ensuring consistency in lab processes and protocols.46 Standardization of testing protocols can also assist police in preparing cases that can be efficiently prosecuted and that can withstand legal and judicial scrutiny. 

5. Suspending, restricting, or revoking driving privileges. Motor vehicle departments typically have administrative and legal protocols in place for restricting, suspending or revoking driving privileges for impaired drivers, and these responses have been effective.47 The same protocols could be (and in some jurisdictions already are) applied to drug-impaired drivers. It seems clear, however, that relying solely on these measures has not been effective—especially for persistent drinkers. It likely follows that these approaches, if implemented as a primary response, would be equally ineffective for persistent drug users, including users of intravenous drugs who are frequently convicted of drug-impaired driving.48 First-time drug-impaired driving offenders, however, may be more effectively influenced to change their behavior by various methods of restricting driving privileges. And some evidence suggests that "use and lose" laws, which include those that authorize driver-licensing actions against persons found to be using, or in possession of, illicit drugs, and against underage persons found to be drinking, purchasing or in possession of alcoholic beverages, improve public safety and reduce subsequent traffic violations overall.49 

Enforcement Responses

6. Implementing high-visibility enforcement, including sobriety checkpoints. Police visibility, focused and directed enforcement—especially during high-risk time frames and in high-risk areas—and regular and highly visible use of sobriety checkpoints have been successful deterrents to alcohol- and drug-impaired driving.50 Although sobriety checkpoints can be resource intensive (and therefore expensive), this enforcement approach has been upheld by American courts as a reasonable intrusion of privacy when implemented properly. The general public typically supports the use of sobriety checkpoints to enforce drunk-driving laws and sobriety checkpoints, particularly when advertised in advance, have increased potential offenders' perceptions that they will be apprehended.51 On the other hand, sobriety checkpoints that have targeted drunk driving fail to detect legal intoxication among many drivers.52 It is therefore likely that checkpoints designed to target drug-impaired driving would also miss a substantial proportion of impaired drivers, given the range of difficulties associated with field drug testing (See response No. 7 below). 

7. Training police officers to be drug recognition experts. Many police departments have trained some officers as drug recognition experts. These experts rely on a standardized process for assessing whether a suspect is drug impaired.53 The use of this systematic approach has assisted many prosecutors in prosecuting drug-impaired driving offenders, although the reliability of the process and the admissibility of the evidence have been subjected to substantial legal challenges.54 Evaluations of the effectiveness of this response have been mixed, but they tend to indicate that officers are reasonably accurate in identifying drug-impaired drivers.55 The National Highway Traffic Safety Administration (NHTSA) has published useful guidance on how to improve the investigation and prosecution of drug-impaired driving cases.56 

Restricting Vehicle Access

8. Impounding, immobilizing, or confiscating vehicles or vehicle license plates of drug-impaired drivers. Impounding or immobilizing vehicles or confiscating license plates, temporarily or permanently, as a method of reducing additional traffic violations and improving overall safety, has been effective at reducing future offending by those driving on suspended or revoked licenses.57 Confiscating license plates of drunk drivers, particularly first-time drunk drivers, has also been effective.58 These responses appear to be working in a variety of locations in the United States and Canada among alcohol- and drug-impaired drivers who are either first-time or repeat offenders.59 Jurisdictions vary with respect to the time when, and under what conditions, permanent vehicle forfeiture can occur. New York City applies such sanctions to first-time and repeat offenders alike, arguing that the vehicle is an instrument of a crime and observing that first-time offenders were responsible for 87 percent of the drug-impaired driving-related deaths. Although there have been concerns about establishing vehicle ownership, about undue impact on family members, and about claims of excessive punishment, vehicle forfeitures have generally been upheld by state and federal courts in the United States.60 

Reducing Drug Use

9. Mandating drug treatment for all drug-impaired drivers. It is unlikely that all first-time drug-impaired drivers were apprehended the first time they drove while impaired. Furthermore, repeat offenders have demonstrated a persistent use of drugs and a willingness to drive while impaired; they have also demonstrated an unwillingness or inability to change either behavior. By and large, it is reasonable to conclude that most convicted drug-impaired drivers are drug users during periods when they are not driving. Drug treatment, including court-mandated treatment or compelled treatment by other means (e.g., drug courts or other drug diversion programs), is often effective at reducing (and sometimes eliminating) drug use and at managing the consequences associated with drug abuse.61 Treatment should be more intensive and last longer for repeat drug-impaired driving offenders (who are likely persistent drug users); even so, treatment has been effective at reducing subsequent collision risk for cocaine and alcohol users.62 Treatment is often less costly than many other criminal justice sanctions, including incarceration; therefore, it should be required for any convicted drug-impaired driver. Treatment, either concurrent with or in lieu of punishment, can be effective, but punishment without treatment is less likely to deter repeat drug-impaired driving.

10. Using electronic-monitoring devices to closely track repeat drug-impaired driving offenders. Offenders who are arrested or convicted more than once for drug-impaired driving merit closer monitoring and supervision by the criminal justice system than first-time offenders. Recent advances in electronic monitoring have suggested that this approach is a cost-effective method of community supervision both before and after convictions.63 Electronic monitors affixed to convicted drug-impaired drivers or their vehicles would allow police to track offenders continuously, to determine whether they are on foot or in a car, and to assess whether they are near such places as drug markets and drug houses. Together with driving restrictions, an electronic-monitoring program that includes a drug-use-monitoring device that can detect illicit substance use occurring within the offender's home or while he or she is driving to or from work would create an effective technological method of preventing continued drug use and of reducing rates of recidivism among convicted drug-impaired drivers. 

Education and Prevention Responses

11. Conducting public-awareness campaigns directed at the general population and targeting high-risk populations.† Like public-awareness campaigns that focus attention on drunk driving, drug-impaired driving campaigns should be broadcast to the general public. Such campaigns should focus on correcting misperceptions about the dangers associated with driving under the influence of drugs—in particular, marijuana. Mothers Against Drunk Driving (MADD) has taken the initiative and developed a number of campaigns such as "If You Are High, You Can't Drive."64 Repeatedly publicizing laws and legal sanctions might also deter drug-impaired driving.65 States and countries that have recently permitted the use of marijuana for medical purposes or decriminalized it altogether, or that are considering doing so, should prioritize public-awareness campaigns because marijuana use will likely increase after decriminalization. Campaigns that emphasize the message across multiple mediums and that engage multiple community groups and stakeholders may be worth pursuing.66 

† See Response Guide No. 6, Crime Prevention Publicity Campaigns, for further information. 

12. Mandating drug-impaired driving education and prevention programs for high-risk drivers. Any new driver should be exposed to educational materials that focus attention on preventing drug-impaired driving. These types of programs should also target older drivers who are prescribed potentially impairing medications (which can be identified when the drivers renew licenses or, better yet, when they are prescribed); first-time and persistent substance abusers who may be at increased risk of offending; and other identified at-risk populations (e.g., those with drug-related arrests, nontraffic convictions and persistent traffic infractions at younger ages, as well as first-time drug-impaired drivers). These programs must move beyond merely providing factual information about the hazards associated with drug-impaired driving, an approach which may not be particularly effective.67 Prevention programs will be more effective if they emphasize increased swiftness and certainty of apprehension, nonlegal sanctions such as shame and loss of friends, concern for others, and awareness of personal-injury risks.68 Furthermore, programs that seek to correct inaccurate perceptions of the risks associated with various forms of drug-impaired driving, including marijuana-impaired driving and driving under the influence of marijuana and alcohol combined, should be developed and adopted.69

13. Educating and engaging physicians and pharmacists regarding prescription drug abuse and drug-impaired driving. Given that a substantial proportion of drug-impaired driving is linked to prescription drugs and prescription drug abuse, doctors and pharmacists (and their assistants) need to be fully informed of, educated about and engaged in responding to this problem. One potential program that focuses on physician support for designated drivers could be considered and adopted.70 A comparable program, supported by pharmaceutical companies and perhaps local transportation companies, could also be considered and adopted: designated drivers would be made available to those who are picking up or continuously using prescription drugs known to impair driving ability. Guides for developing such programs are available.71

14. Encouraging physicians and pharmacists to educate their patients about the link between the use of certain prescription drugs and impaired driving. Point-of-sale education programs are a viable method of reaching the general population and specific at-risk populations using prescription drugs, such as the elderly and the mentally impaired. These types of warning programs might have a meaningful impact because they are delivered proactively from a medical professional rather than reactively from a law enforcement officer or a court. Such programs should seek to identify drugs that are potentially impairing, to explain the consequences of using these substances before driving and to articulate the laws and punishments (including rate increases in automobile liability insurance) that apply to drug-impaired driving.72 Progressive programs might also include readily available transportation alternatives, home delivery of potentially impairing substances, clearly readable warning labels on containers, and other such methods for ensuring that substance users are effectively reached and are likely to understand the risks and consequences associated with driving while medicated. 

Responses with Limited or Unknown Effectiveness

15. Confining convicted drug-impaired drivers to their homes in the absence of close monitoring (electronic or otherwise). Home confinement, while possibly minimizing some subsequent offending, does not necessarily address the problem of substance abuse, and persistent drug users are unlikely to abstain in the absence of additional coercive or restrictive measures. Use of electronic monitoring as a method of enforcing home confinement is a preferred option, particularly if the offender understands the surveillance capability of the monitoring device and if swift, certain and severe sanctions are in place for noncompliance with, or other violations of, confinement conditions. Home confinement, combined with mandatory treatment and electronic monitoring, has been tested with drug offenders and has generated some positive results.73

16. Developing ignition interlocking devices and requiring convicted drug-impaired drivers to install them. Use of ignition interlocking devices, properly installed and maintained for a sufficient amount of time, has been effective in deterring some first-time and repeat drunk drivers from reoffending.74 Nevertheless, there have been some disadvantages to this approach. Some offenders do not own cars (and the impoundment of which may be part of their punishment—See No. 8 above); others may not install the devices even if ordered to do so; and ongoing monitoring may present substantial resource challenges for criminal justice systems. Those challenges would need to be considered if technological advances allow for drug testing by ignition interlocking devices in the future. At present, such devices are neither widely available nor validated as useful.

17. Developing and implementing devices that monitor drug use. Current technology allows for ongoing monitoring of the amount of alcohol in the blood. Similar technology may be developed for ongoing drug monitoring and testing of sweat, blood, urine, or saliva. At this point, such technology is in the early stages of development, although there are some preliminary indications that sweat-testing patches might prove useful in the future.75 If you are part of the criminal justice system in your jurisdiction, you should be aware of new scientific and technological developments regarding the technology of remote drug-monitoring devices. Such technology might also be used in conjunction with electronic-monitoring technology, which would allow police to track offenders and test them for drugs at all times and wherever they go.

18. Incarcerating drug-impaired drivers. Incarcerating convicted drug-impaired drivers, particularly repeat offenders and those prosecuted for deaths associated with crashes, obviously prevents offenders from driving during confinement and can deter them from further drug-impaired driving once released, but the deterrent impact on all drivers may be less than anticipated. Much of the deterrence literature suggests that swift and certain responses, rather than severe consequences alone, are likely to deter future offending, particularly if offenders know clearly how they are expected to behave in the future and the consequences for failing to do so. For offenders who are unresponsive to alternative sanctions, to substance abuse treatment (either compelled or voluntary), or to other responses, long-term incarceration is a viable, although expensive, strategy for ensuring increased public safety for some period of time.76

19. Substantially increasing fines for drug-impaired driving offenses. In many countries, increasing fines has historically had minimal effects on recidivism rates among drunk drivers or as a general deterrent to drunk driving. Often the fines are not paid, and many jurisdictions lack the resources to enforce payments unless the offender comes into contact with the criminal justice system in the future. Hence, there is little reason to believe that this approach would have a meaningful impact on drug-impaired drivers. However, Australia and Sweden have adopted fine systems that are closely linked to offenders' income levels and to the seriousness of the offense, and within those systems, fines have been more effective in reducing recidivism rates.77 Nevertheless, the magnitude of the fine relative to the offenders resources and the seriousness of the offense may not have been equitably balanced in many countries. Therefore, fine systems may need further exploration as one potential response to drug-impaired driving.