When it comes to DWI, that's all we have.

According to a recent news report, our state is no longer in the national top 10 for alcohol-related highway deaths. Congrats to all who helped-that's quite an achievement.


Treatment gets only a passing mention in that article, but future success will depend as much on treatment as enforcement and public awareness. That's because of the unique nature of the drunk driving problem.

Anthropologists suggest that human beings have been using and abusing alcohol for some 10,000 years-much longer than we've had the written word. The automobile is but a recent addition. It gives the intoxicated a devastating weapon-one that routinely results in death and destruction to self and others.

Every society that has alcohol and automobiles has struggled with drunk driving. There have been no perfect solutions. None are likely in the future. Since we haven't been able to eliminate the problem, the goal has become to minimize its adverse impact.

Good DWI interventions are based on the notion that drunk drivers are not all alike.

Imagine your county arrests 1,000 first-time drunk driving offenders each year. The court applies sanctions: a court appearance, driver education, a fine and the threat of more serious consequences for a repeat offense.

Most of the offenders respond as intended. They alter their habits and, as a result, aren't arrested again.

The rest don't respond as well. Some are arrested again within a few years. Or months. Or weeks. Or even days.

Why this disparity in response? Because the two groups were different from the outset. The first group might be called irresponsible drinkers. Their flaw was essentially one of decision making. Something they did was causing them pain, so they changed it.

The second group operates from another rulebook. Some habitually abuse alcohol for  emotional reasons. Others suffer from a chronic disease that leads to progressive loss of control over drinking.

It's the nature of such drinkers to use alcohol in spite of the adverse consequences. For them, enforcement and punishment alone are not enough.

Some examples from my own experience: the woman who was arrested three times in four years, all at sobriety checkpoints in the same general area. Her conclusion: The police unfairly targeted her because of her sex.

The accountant who became so frustrated by his repeat DWI arrests that, after the last one, he put his car up on blocks and sold the wheels. The next arrest came one year later, in a borrowed Toyota.

The firefighter who ran his truck off the road one dark night. Fearing arrest if he called for help, he crawled instead to a nearby field and passed out. He woke the following morning as the wheels of a farmer's tractor passed over his rib cage.

Just anecdotes, but they illustrate a point. Though recovery was possible- every one of these individuals have been sober at least five years-it wasn't easy. All of them needed plenty of help-help that they didn't welcome at the time.

The thinking of such individuals is dominated by defenses. Those include denial (simply not recognizing the problem); rationalizing (coming up with excuses); externalizing (blaming others); minimizing (insisting things are not that bad yet); and intellectualizing (arguments over details and definitions). Sure, the alcoholic hopes to fool you and me. But more importantly, he needs to fool himself.

Studies suggest that some offenders drive drunk 1,000 times for every time they get caught. And when they do, they feel cheated. "Why did it happen now?" they ask. "Instead of last week?"

This group won't learn to successfully moderate their drinking, no matter how hard they try (and they do try). For them, any alcohol at all is one too many.

For these individuals, incarceration is often of more value as a threat than a reality. Jails and prisons aren't really designed for sick people (and in many cases, would rather not have them). Second, extended jail terms are prohibitively expensive. Third, the offender's family is often punished along with the offender. And fourth, jail or prison alone frequently doesn't work.

Eventually the alcoholic leaves prison and more often than not, resumes old behavior. Take Duane from Baltimore. His cellmate showed him how to strain hair tonic through bread, making it drinkable. Duane binged periodically throughout his four-year sentence, and was arrested again within a month of his release.

So what does work, if only imperfectly?

There's an impressive body of evidence on effective interventions. The bones of a good strategy include two basic elements:

Consistent enforcement: New Mexico has made real strides here. The potential DWI offender must believe that arrest and prosecution are real possibilities. That means having enough officers on the street. If those officers are discouraged from making DWI arrests, or get reassigned to other duties, or if there are chronic shortages, the likelihood of arrest immediately goes down.

Don't think potential offenders don't notice this. They count on it.

Checkpoints can be popular because they require few personnel and can be targeted to high-risk locations. So are hotlines where other drivers can call in to report suspected offenders on the road. But in the final analysis, it always seems to come down to persistent patrolling.

Consistent availability of treatment options. The courts need alternatives to simple incarceration. That means outpatient and residential services that are both affordable and available. If the offender needs prolonged incarceration, then treatment has to be included.

I've noticed that where DWI strategies fail, it's often because of inconsistent funding. There's a tendency in government to respond to falling DWI rates by reducing funding. Then we're all surprised when the rates go back up.

DWI can't become a political football. An effective strategy must outlive changes in administration and legislature, to become a permanent part of our social infrastructure.

Otherwise, no strategy can work-even imperfectly.