In response to an Austroads tender to investigate options for rehabilitation in alcohol interlock programs, the Centre for Accident Research and Road Safety — Queensland (CARRS-Q) has undertaken a program of research. The project is directly relevant to the Australian National Road Safety Strategy 2011-2020 which identifies irresponsible road users as a major road safety problem. To address this issue, the strategy outlines steps to reduce high risk behaviors, one of which is drink driving. The current project directly addresses one of the identified first steps to reducing irresponsible road use: 36 (d) “Investigate the option of requiring demonstrated rehabilitation from alcoholdependence before removal of interlock conditions.” The findings are summarised and recommendations arising from the project are presented here. The program included four objectives: * Development of a matrix outlining existing policies in national and international jurisdictions with respect to treatment and rehabilitation programs and criteria for eligibility for interlock removal; * Critical review of the available literature with a focus on evaluation outcomes regarding the effectiveness of treatment and rehabilitation programs; * Analysis and assessment of the strengths and weaknesses of the programs/approaches identified; and * Development of options with an evidence base for consideration by licensing authorities. The outcome of this project may form the basis of a subsequent project to develop implementation guidelines for Australian and New Zealand licensing authorities. As such developing, pilot testing or evaluating a new intervention, drafting policy and drafting legislation for implementation by jurisdictions are outside the scope of the current project. The current report may be considered as four components: matrix, literature review, strengths and weaknesses analysis, and identification of options for consideration by licensing authorities. To provide the context in which interlocks and alcohol treatments are currently being applied, a matrix to outline existing policies is presented. A separate matrix is presented for Australian and international jurisdictions including details of interlock and alcohol treatment policies, from a road safety perspective. A supplementary matrix is also presented which specifically focuses on the type of treatment approaches currently being implemented. Full details of interlock and treatment programs in each jurisdiction investigated can be found in Appendices A to D. Secondly, a literature review was conducted to investigate treatments for problematic alcohol use and measures to assess their effectiveness. This review initially focuses on the broader domain of treatment for problem alcohol use and then reviews treatments with a specific aim to separate drinking from driving. The review then examines methods for determining if a problem alcohol user has been rehabilitated. Drawing from information in the literature review and matrix tables, a strengths and weakness analysis was undertaken for each of the treatment approaches identified in the earlier two stages. This analysis includes consideration of the effectiveness, cost, time to implement, delivery method, and geographical implications for each approach. As with the literature review, the strengths and weakness analysis has two categories of treatments; those focused on alcohol rehabilitation and those focused on the separation of drinking from driving. Finally, the report identifies options for consideration by licensing authorities. This has been informed by the findings from a modified Delphi technique conducted with international experts in this area. The authors used the information obtained in the first three project components to generate potential options for licensing authorities. To further refine and develop these options, they were presented to a group of invited experts recruited at the International Council on Alcohol, Drugs and Traffic Safety Conference, which was held in Brisbane in 2013. Following that presentation, experts engaged in open discussion and follow up email consultation to identify the most important issues for consideration with interlock treatment programs in making recommendations to licensing authorities for best practice. The report ends with details of recommended options and an overall discussion. (Author/publisher)
Samenvatting