Transdermal alcohol monitoring combined with contingency management for driving while impaired offenders: A pilot randomized controlled study

ABSTRACT

Objectives: In a pilot randomized controlled trial of contingency management (CM) and transdermal alcohol monitoring (TAM) with offenders driving while impaired by alcohol (DWI), perceptions regarding the acceptability of a TAM device, recruitment issues, and the impact of CM and TAM on alcohol use over a 6-week period were evaluated. The results aimed to inform the design of future trials and programs involving CM and TAM for DWI remediation.

Methods: TAM devices were affixed to 37 voluntary, community-recruited male DWI offenders with problem alcohol use. They were randomized to one of 3 groups: (1) CM; (2) alcohol use feedback (FB); and (3) TAM device only (CTL). Quantitative and qualitative data were gathered on the acceptability of TAM devices and recruitment, and alcohol use was monitored via TAM and self-report.

Results: The TAM device was perceived positively, with benefits for reducing drinking noted. Nevertheless, some of its inconveniences appeared to influence participant recruitment and attrition, including its large size and limited water resistance. TAM data revealed a significant main effect of time for reduction in weekly peak transdermal alcohol concentration (P = .02), with a decrease between means of weeks 1 and 6 (M  =  0.15, SE = 0.02 vs. M = 0.09, SE = 0.02; P = .005). No significant group effect was detected.

Conclusions: TAM is a viable adjunct to CM with DWI offenders, though the TAM device used here may influence both study recruitment and adherence. These findings can guide the design of future studies into CM and TAM for DWI remediation.

KEYWORDS:

• Alcohol
• transdermal alcohol monitoring
• contingency management
• driving under the influence (DUI)

Acknowledgments

The authors thank Peter Marshall and Winnie Tan from Recovery Science Corporation, a Canadian company providing alcohol monitoring services and supplying the anklets used in the study as well as access to the data and troubleshooting; Mike Iams, Matthew Mitchell, Chris Miyashiro, Lou Sugo, and Don White from Alcohol Monitoring Systems for their input on using SCRAM technology; Marylène Bérard for handling participant feedback; Caroline Champagne, Lidia Corado, Sarah Doucet, Marie-Maxime Lavallée, Roxanne Prévost, and Laurence Vézina-Poirier for providing assistance with TLFB interviews at study exit; Lucie Legault and Lysiane Robidoux-Léonard for their assistance with recruitment; and Candide Beaumont of the Quebec program responsible for evaluating DWI offenders seeking relicensing (Programme d’évaluation des conducteurs automobiles) and Lyne Vezina of the Quebec Licensing and Insurance Bureau (Société de l'assurance automobile du Québec) for their study recruitment support.

Additional information

Funding

This study was supported by a Canadian Institutes of Health Research team grant (SAF-94813). The first author was supported through PhD training awards from the Quebec Research Funds for Nature and Technology–Quebec Ministry of Transportation Award (Fonds de recherche du Québec–Nature et technologies, bourse du ministère des Transports du Québec), Auto21 Networks of Centres of Excellence, and the Quebec Research Network for Road Safety (Réseau de recherche en sécurité routière du Québec). The last author was supported through a career award from the Quebec Health Research Fund (Fonds de recherche du Québec–Santé).