How Alcohol Treatment for a DUI Works
In all 50 states, driving under the influence (DUI) is defined as getting behind the wheel with a recorded blood alcohol content (BAC) of 0.08 percent or higher. A DUI charge can come with fines, loss of license and/or automobile, jail time and/or court ordered addiction treatment. Those who want to drive again typically need to complete some form of addiction treatment, which may include medical detox, rehab, and support group work.
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Each state determines the laws concerning the operation of a vehicle while under the influence of alcohol or other drugs. For this reason, a discussion of the driving under the influence (DUI) process is necessarily generalized.
All DUI cases begin with a law enforcement official having a reasonable suspicion that a driver has been drinking alcohol and/or consuming other drugs.
In some instances, this detection may occur as part of a randomized policy of stopping cars on heavy “party nights”or after a local event, such as a sports game. In other instances, police may be tipped off by a concerned citizen. In most instances, the driver displays road behavior that alerts police to a potential problem.
After a driver is stopped, police will make an effort to determine if the individual is actually intoxicated. Although police only need a reasonable suspicion to stop a driver (a low standard), they need probable cause to make an arrest (a higher standard). To support probable cause for a potential arrest, the police may ask the driver to perform a field sobriety test. During a field sobriety test, the police most may request that the driver perform an action, such as:
- Walking in a straight line
- Balancing on one leg
- Reciting the alphabet from Z to A
- Following a beam of light from side to side with the eyes
Another form of police DUI testing is to ask the driver to take a roadside breathalyzer test. It is important to understand that both the field sobriety test and breathalyzer test are voluntary. The refusal to take these tests does not itself provide police with probable cause to make an arrest, but it doesn’t necessarily stop them from making an arrest either. The refusal could serve as a weighted factor in police officers’ decisions to make an arrest.
If the police do decide to make an arrest (whether or not a field test has been conducted), the next step will be to go to the police station or a local hospital for one of the three main DUI testing options of breath, blood, or urine (the least common method). According to federal constitutional law, when individuals are in custody, they receive specific protections, including the right to speak with an attorney. Some states provide that the DUI testing has to wait until after the arrested driver speaks with an attorney while other states may allow the testing to occur first.
Each state sets different penalties for DUI convictions. In general, during the court hearing, the individual will be fined and face driving license revocation for a set period of time.
Some states require a mandatory jail sentence, even if it is the offender’s first time. Many convicted drivers are placed on probation and required to perform community service. If there are aggravating circumstances, such as a minor having been present in the car or prior DUI convictions, some jurisdictions impose harsher penalties. In some cases, the court will order the convicted person to engage some form of drug education or rehab treatment services.
If the individual is found to have an alcohol dependency problem or at least a problematic relationship with alcohol, a treatment referral will be made to one, or a combination of, the following:
- A medical detox program
- An outpatient alcohol recovery program
- An inpatient alcohol recovery program
- A local support group, such as Alcoholics Anonymous
When it comes to court-ordered alcohol abuse recovery treatment, there may be a concern as to its effectiveness because the decree is coming from an outside authority and not the convicted individuals themselves. It is well established that recovery must come from within, but that does not undermine the role of outside encouragement or even a court order. According to the National Institute on Drug Abuse, most studies support that individuals who are referred to treatment through the legal system have treatment outcomes as good as, or better than, those individuals who entered treatment on their own. In addition, individuals under legal pressure to attend rehab tend to have higher rates of attendance and remain in rehab for longer periods of time ” both things that contribute to better chances at sustained recovery.
Is Alcohol Treatment Necessary?
To answer this question, the first consideration is whether an alcohol abuse problem is present. A DUI conviction is proof that the individual made a very poor decision on the driving day in question but that even alone is not evidence of an alcohol problem. Short of a counselor associated with a DUI court recommending treatment, an individual and concerned family and friends may struggle with the decision of whether or not admission to a structured rehab program is warranted. To help understand if treatment is necessary, it is critical to know the warning signs of alcohol abuse. According to the National Council on Alcoholism and Drug Dependence, the following are some outwardly visible signs that alcohol abuse is present:
- Ongoing neglect of personal, work, and/or family responsibilities
- Spending a disproportionate amount of time, energy, and financial resources on drinking
- Poor performance at work or school
- The use of alcohol in combination with other drugs
- Continuing to drink despite the negative consequences associated with alcohol, such as hangovers, poor work performance, and relationship problems
- Facing legal problems, including being arrested for disorderly conduct, fighting, or otherwise disturbing the peace
- Drinking to cope with stress or life problems
In addition, since alcohol is an addictive drug, a person who consumes a high volume of alcohol for a prolonged period of time will develop the hallmarks of physical dependence, specifically tolerance and withdrawal. When the human body is repeatedly exposed to alcohol, its natural reaction is to build a tolerance. As a result, over time, a person will require a greater volume of alcohol in order to experience the familiar intoxication effect. If the person ceases to drink or significantly reduces the usual volume of alcohol consumption, the withdrawal process may be triggered.The severity of alcohol withdrawal depends on a host of factors, including the volume of consumption and length of abuse. Withdrawal symptoms may begin as early as a few hours after last use or even days later. For some individuals in withdrawal, symptoms may persist for weeks. Common symptoms of alcohol withdrawal include:
- Anxiety and confusion
- Nausea and vomiting
- Alcohol cravings
- Increased heart rate
In more serious cases, a person in alcohol withdrawal may experience:
- Extreme agitation
- Severe confusion
- Hallucinations (visual, auditory, and/or tactile)
Although it may not be common knowledge, alcohol can be one of the most severe drugs from which to withdraw, and the process can be life-threatening in some cases. It is important to be aware of the possibility of a severe withdrawal process when considering whether medical detox is necessary. For some individuals in alcohol withdrawal, especially long-term heavy drinkers, a medically supervised detox is generally the most advisable first step to recovery. After medical detox, the recovering person will progress to abstinence maintenance treatment that includes extensive individual and group therapy. Medical detox addresses the physical aspects of alcohol abuse while therapy focuses on the psychological underpinnings of abuse.
The Importance of Medical DetoxAt the point of treatment, there is little difference between a person who is entering rehab after a DUI and one who is admitted for a different reason. Although a DUI-involved client may have certain court requirements to meet, treatment itself will not be influenced. A drug recovery program admissions counselor, working in conjunction with a team of addiction treatment professionals, can determine the most advisable course of treatment for alcohol dependency or alcoholism. When a medical detox is necessary, depending on the severity of the actual or possible withdrawal symptoms, an outpatient or inpatient detox may be recommended. If severe withdrawal symptoms are present, medically supervised detox can occur either in a dedicated facility or a hospital.
To safely and effectively manage the withdrawal process, attending medical staff may use approved medications, such as benzodiazepines like Valium, Ativan, or Librium. This class of prescription sedative drugs can help to relieve the confusion, anxiety, and shakiness associated with alcohol withdrawal as well as reduce the likelihood of seizures. In addition to benzodiazepines, the medical team may address other symptoms with other types of medications such as antipsychotics (to help with agitation and hallucinations), beta-blockers (to lower a high heart rate), and/or an anticonvulsant such as Dilantin (for individuals with an underlying seizure disorder). In less severe cases, attending medical staff may use anticonvulsant drugs, such as Tegretol. Over-the-counter medications may also be used to ensure the process is as comfortable as possible.
Detox alone is never a sufficient treatment approach; it must be followed by comprehensive treatment to address the reasons behind the alcohol abuse.
Alcohol abuse arises from a constellation of psychological, biological, and environmental factors. For this reason, a multidisciplinary approach to alcohol abuse treatment is required. Although the services of drug rehab programs vary among facilities, at a minimum, centers offer therapy in both an individual and group setting. In addition to therapy, effective research-based treatment approaches include group recovery meetings (such as Alcoholics Anonymous), drug counseling and education, family therapy, and holistic treatments (as a supplement to traditional treatments), such as yoga, meditation, and acupuncture.
The maintenance of sobriety is not only key to regaining one’s driver’s license after a DUI, but keeping it.
It is critical to understand that states impose increasingly severe penalties for each DUI conviction. DUI aside, ongoing sobriety can help to ensure health and life satisfaction in general. According to one medical source, within four years of treatment, the vast majority of individuals with an alcohol abuse problem will relapse; however, an effective aftercare program after rehab ends can help individuals to avoid relapse. While relapse is a reality of recovery for some individuals, it should never be construed as a failure. Rather, a relapse can be seen as part of the ongoing process of recovery. It often signifies that a shift in the recovery approach should be made.
As PsychCentral discusses, many individuals in long-term recovery from alcohol abuse credit the support they receive from Alcoholics Anonymous (AA) after the intensive rehab process ends. After graduation from a rehab program, support networks, such as 12-Step groups, play an instrumental role in relapse prevention as well as the development of healthy new life skills. AA, and other member-led recovery groups, can provide a recovering person with ongoing community support as well as a one-on-one sober sponsor.
Individuals are guided to rehab by different paths, and a DUI may serve as motivation to seek sobriety.