Assessment and Treatment of Repeat Impaired Drivers

Transcription

1 Assessment and Treatment of Repeat Impaired Drivers Cross Agency Presentation to Addiction Leadership Day Wellington 19 April 2012

2 Overview of Panel Discussion Implementing Alcohol Interlock Devices Kathryn McIver, Ministry of Transport Assessments for Section 65 of Transport Act Mark Pugin, NZTA Working with Repeat Impaired Driver Guidelines - Ashley Koning, Matua Raki Developing Repeat Impaired Driver Treatment Programmes Peter Kennerley, Ministry of Health Developing a Repeat Impaired Driver Education Programme Margaret Stevenson-Wright and Anne Dowden, NZTA Interactive Questions and Answers

3 S.65 Transport Act Assessments Quantity approximately 1200 per year Quality of Assessments what we are looking for Removal Decision fit and proper person Process Problems funding eligibility and payment

4 Impaired Driving Treatment Programmes Impaired driving is used rather than drink driving to take into account all substance impaired driving in NZ In ,182 people were convicted of impaired driving for at least the third time The majority of these were not referred for assessment or treatment Many, though not all, may have a substance use problem All have a problem making choices about driving under the influence of substances

5 Impaired Driving Treatment Programmes cont d Currently we have at least nine group education/rehabilitation/treatment programmes operating in isolation from each other in NZ These appear to have been developed by individuals in community agencies, city councils or Community Alcohol and Drug Services Interventions share a common goal but not necessarily approaches Programmes range in length and intensity from 3x2 hour sessions to 12x2 hour sessions Interventions can include education about the impact of alcohol and other substances, therapeutic group work, victim impact presentations, relapse prevention and skill development to manage negative emotions and conflicts Most programmes use motivational approaches to engage impaired drivers and CBT components to help them to learn new skills

6 Impaired Driving Treatment Guidelines The guidelines aim to provide information about impaired driving and a description of current internationally accepted best practice interventions to reduce impaired driving - Education about alcohol and substances - Motivational Enhancement and CBT for substance and lifestyle problems - Supervision or Probation Services not currently providing dedicated programmes will be able to use the guidelines to plan and develop programmes that suit the needs of their region and population Matua Raki intends to provide training to complement the guidelines

7 Developing New Treatment Programmes $1m of new funding has been allocated by Government to deliver AOD treatment programmes for repeat drink drivers Process is to identify elements of preferred practice Service Specification to be developed for this service Tender for the delivery of services in second half of 2012 Welcome proposals from Māori providers that can incorporate relevant cultural context around treatment Services to be evaluated

8 Driver Education Project (inform, advise, educate) Safer Journeys Action: Education of substance impaired drivers Drink drivers / Drug Drivers Drivers impaired by illicit drugs, medications and/or alcohol

9 Driver Education Project (inform, advise, educate) Margaret Stevenson-Wright, Senior Advisor Education, NZTA, Anne Dowden, Anne Dowden-REWA, Contractor,

10 Driver Education Project (inform, advise, educate) Stakeholder Group input, advice, collaborations Update in the literature (focus: drug driver education) Key informant interviews Problem definition (size + features of driver pop) Strategic analysis (what are the priorities) Sector review (what's happening/could happen next?) Education options

11 Driver Education Project (inform, advise, educate) NZ drivers internet survey: four in ten (41.7%) reported driving under influence of medications or illegal drugs in previous 12 months - 1 in 4 (26.2%) with illicit drugs (mostly this was cannabis; 1 in 4 overall (24.5%)) - 1 in 10 (9.2%) with prescription medications (Hammond 2009) (n=1,124; caution over-sampling drug users)

12 Driver Education Project (inform, advise, educate) 2. Seriously injured 'at fault' drivers (n=453) hospital blood tests: 'drink drivers' (n=228) (30+ mg alc. per 100 mls) more than four in ten (41%) tested positive for drugs unlikely hospital administered 'non drink drivers' (n=225) more than one in four (28%) tested positive for drugs - 24% of these had cannabis - 5% of these had methamphetamine (Poulsen 2011)

13 Driver Education Project (inform, advise, educate) 3. Drink driver blood alcohol samples (n=45) blood sample retested for drugs: nearly one in three (31% or n=14) tested positive one in five (20% or n=9) for cannabis other drugs: methadone, benzodiazepines & venlafaxine. (Poulsen 2011)

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16 Interactive Session Questions from the Floor and Questions from the Panel Are NZers ready to hear about drug driving (impaired driving caused by alcohol and drugs?) What information is key? Who is key? Should we routinely ask all clients whether they ever drive while they are impaired? What works with repeat drink drivers, and what doesn't work? How do you get past denial that there is a problem? How do you motivate repeat drink drivers as part of your AOD treatment? Where do you see the current state of knowledge amongst AOD practitioners?