Greg Midgette

Efficacy of frequent monitoring with swift, certain, and modest sanctions for violations: insights from South Dakota's 24/7 sobriety project

OBJECTIVES We examined the public health impact of South Dakotas 24/7 Sobriety Project, an innovative program requiring individuals arrested for or convicted of alcohol-involved offenses to submit to breathalyzer tests twice per day or wear a continuous alcohol monitoring bracelet. Those testing positive are subject to swift, certain, and modest sanctions. METHODS We conducted differences-in-differences analyses comparing changes in arrests for driving while under the influence of alcohol (DUI), arrests for domestic violence, and traffic crashes in counties to the program with counties without the program. RESULTS Between 2005 and 2010, more than 17,000 residents of South Dakota-including more than 10% of men aged 18 to 40 years in some counties-had participated in the 24/7 program. At the county level, we documented a 12% reduction in repeat DUI arrests (P = .023) and a 9% reduction in domestic violence arrests (P = .035) following adoption of the program. Evidence for traffic crashes was mixed. CONCLUSIONS In community supervision settings, frequent alcohol testing with swift, certain, and modest sanctions for violations can reduce problem drinking and improve public health outcomes.

Cocaine's fall and marijuana's rise: questions and insights based on new estimates of consumption and expenditures in US drug markets

AIMS Drug policy strategies and discussions often use prevalence of drug use as a primary performance indicator. However, three other indicators are at least as relevant: the number of heavy users, total expenditures and total amount consumed. This paper stems from our efforts to develop annual estimates of these three measures for cocaine (including crack), heroin, marijuana and methamphetamine in the United States. METHODS The estimates exploit complementary strengths of a general population survey (National Survey on Drug Use and Health) and both survey and urinalysis test result data for arrestees (Arrestee Drug Abuse Monitoring Program), supplemented by many other data sources. RESULTS Throughout the 2000s US drug users spent in the order of

The whole is just the sum of its parts: limited polydrug use among the "big three" expensive drugs in the United States.

100 billion annually on these drugs, although the spending distribution and use patterns changed dramatically. From 2006 to 2010, the amount of marijuana consumed in the United States probably increased by more than 30%, while the amount of cocaine consumed in the United States fell by approximately 50%. These figures are consistent with supply-side indicators, such as seizures and production estimates. For all the drugs, total consumption and expenditures are driven by the minority of users who consume on 21 or more days each month. CONCLUSIONS Even for established drugs, consumption can change rapidly. The halving of the cocaine market in five years and the parallel (but independent) large rise in daily/near-daily marijuana use are major events that were not anticipated by the expert community and raise important theoretical, research, and policy issues.

The Effect of Montana's 24/7 Sobriety Program on DUI Re-arrest: Insights from a Natural Experiment with Limited Administrative Data

Data from surveys of arrestees and the household population in the U.S. suggest there is only modest overlap among demand for the big three expensive illegal drugs (cocaine/crack, heroin, and methamphetamine). In particular, the number of chronic users of these substances (defined as consuming on four or more days in the previous month) is only about 10% below a naïve estimate obtained by simply summing the numbers of chronic users for each of the three substances, while ignoring polydrug use entirely. This finding does not gainsay that polydrug use is common or important. One would estimate greater overlap if one adopted a more expansive definition of polydrug use (e.g., has the individual ever used another substance at any time in their life) or a more expansive list of substances (e.g., allowing marijuana or alcohol to count as one of the substances makes polydrug use seem much more common). However, it does suggest that when focusing on the illegal drug markets that generate the most crime, violence, and overdose death in the U.S., one can usefully think of three more or less separate markets populated at any given time by largely distinct populations of drug users.

Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state

Alcohol imposes significant social costs on the residents of Montana. The state has one of the highest alcohol-related traffic fatality rates in the nation, and alcohol accounts for more than one-eighth of deaths among working aged adults statewide. 24/7 Sobriety requires alcohol-involved offenders to abstain from alcohol and submit to frequent alcohol testing; those failing or missing a test face an immediate, but brief, jail term. The State of Montana began piloting 24/7 among driving-under-the-influence (DUI) arrestees in Lewis and Clark County in early-2010 and expanded to 22 counties with the passage of House Bill 106 in May 2011. The program also grew to include other alcohol-involved offenses, though DUI arrestees account for more than 75% of program participants. In Montana, 24/7 participants are monitored for an average of 160 days, with a median time of 104 days. Using data from everyone who was convicted of their second DUI charge (DUI-2) from January 2008 to August 2014, this analysis examines the effect of 24/7 participation on the probability of DUI re-arrest for participants within twelve months of their second (DUI-2) arrest date. Results from bivariate probit models which instrument with 24/7 availability to account for potential selection issues provide suggestive evidence that 24/7 participation reduced the probability of DUI re-arrest in Montana (perhaps on the order of 45% to 70% when considering both our main results and sensitivity analysis findings), but missing criminal history information for approximately half of the sample precludes us from making stronger inferences about causality.