24/7 Sobriety Monitoring Cuts Risk for Death in Half

Mortality rate within five years of drunk driving arrest lower for participants in a 24/7 alcohol monitoring program

By Lori Solomon HealthDay Reporter

FRIDAY, March 3, 2023 (HealthDay News) — A 24/7 alcohol monitoring program lowers the death rate for people arrested for drunk driving and other alcohol-involved offenses, according to a research letter published online March 1 in JAMA Psychiatry.

Nancy Nicosia, Ph.D., from RAND Corporation in Boston, and colleagues examined the association between 24/7 sobriety programs and time to mortality using individual-level data. The analysis included linked criminal history and mortality data for individuals arrested for driving under the influence (DUI) of alcohol in South Dakota (2004 to 2011), including 11,827 24/7 participants and 48,834 nonparticipants.

The researchers found that the naive Cox model produced the most conservative estimate (hazard ratio, 0.88; 95 percent confidence interval, 0.77 to 1.00). The researchers’ preferred two-stage residual inclusion Cox model of time to mortality with individual frailty (2SRI-frailty) showed a substantially larger effect size (hazard ratio, 0.55; 95 percent confidence interval, 0.40 to 0.75), with 2SRI-frailty-based survival curves showing that 24/7 participants consistently experienced lower risk for mortality than nonparticipants. While the magnitudes vary, the 2SRI-frailty results were robust to alternative selection of index arrests. Lastly, the bivariate probit model estimated a 55 percent lower probability of death for 24/7 sobriety participants within five years.

“These findings add a public health dimension to the growing evidence that the 24/7 approach improves public safety by reducing rearrest,” Nicosia said in a statement. “We believe this is the first evidence that such programs may also improve health outcomes for those who are enrolled.”