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A Natural Experiment to Test the Effect of Sanction Certainty and Celerity on Substance-Impaired Driving: North Dakota’s 24/7 Sobriety Program

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Evaluate the deterrent effect of a program that increases the certainty and celerity of sanction for arrestees ordered to abstain from alcohol and other drugs on substance-impaired driving arrests.


We examine participant compliance with orders to abstain from alcohol and other drug use via breathalyzer, body-worn continuous alcohol monitoring devices, transdermal drug patches, and urinalyses. We then evaluate the impact of the 24/7 Sobriety program on substance-impaired driving arrests. Using variation across counties in the timing of program implementation in North Dakota as a natural experiment, we use difference-in-differences fixed effects Poisson regressions to measure the program’s effect on county-level arrests for substance-impaired driving.


Over half of participants ordered to abstain from substance use complete 24/7 Sobriety without a detected substance use event. At the county level, the program is associated with a 9% reduction in substance-impaired driving arrests after accounting for the impact of oil exploration in the Bakken region, law enforcement intensity, alcohol availability, whether the state’s large universities were in session, and socio-demographic characteristics. We find that the Bakken oil boom is associated with a 22% increase in substance-impaired driving arrests.


The results suggest frequent monitoring combined with increased sanction celerity deters substance use-involved crime. While the results are generally consistent with an earlier study of 24/7 Sobriety in another state, differences in the study outcome measures implementation choices across states make direct comparisons difficult. More can be learned by conducting randomized controlled trials that vary time on program, testing technology, and/or level of sanction.

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  1. However, in the specific context of driving under the influence of alcohol, Hansen (2015) finds that graduated sanctions at increasing blood alcohol content thresholds (BAC) deter drunk driving recidivism.

  2. While innovative, the program was not without controversy. The program required participants to pay $1 per breathalyzer test or $6/day for alcohol monitoring bracelets (plus fees for applying and removing the bracelet), thereby raising concerns about financial burden for participants. The program developers responded, however, that participants were generally spending more than that on alcohol each day.

  3. In North Dakota, participants monitored for alcohol use typically begin using breathalyzers on the day they are enrolled, but are eligible for CAM after completing between week and a month of compliance to the breathalyzer-based program.

  4. According to interviews conducted with program administrators in the state, this tendency is a pragmatic response to mitigate the administrative burden on staff, to reduce commute burden for those participants in rural areas or those who travel often for work (e.g., periodic work in the Bakken oil fields in the state’s northwest).


  5. All participants listed as active as of the data censoring date were assumed to be participating as of the end of 2015, the study period.

  6. The share of participants that participate in a county other than their residence is small. For example, individuals commute long distances to work in the Bakken oil fields; approximately 7% of those who participate in the Bakken region report residing elsewhere.

  7. Administrative data provided by the State of North Dakota did not include identifying characteristics, so repeat enrollment under multiple participant identification numbers cannot be determined.

  8. According to state officials, these data were the most complete and accurate records of DUI arrests available and generally include larger counts of offenses than FBI Uniform Crime Reports.

  9. Data for calendar year 2007 were not available for this analysis, so we interpolated missing values using a Poisson-based multiple imputation. The findings reported are robust to model specification and imputation method.

  10. We define the Bakken Labor Expansion variable to equal one for Dunn, McKenzie, Stark, and Williams county between March 2010 and April 2015 and zero otherwise.

  11. The cost of each testing medium to participants differs. The conditions under which participants are assigned to each testing mechanism may also vary in unobservable ways. Thus, we caution against assessments of relative effectiveness without a randomized controlled experimental design.

  12. This leads to a small set of counties breaking the 40% threshold by the end of the study period, so we subset the data to counties that either never met the threshold or had at least twelve months of post-enactment data (see Fig. 1). This resulted in exclusion of 19% of the sample.

  13. While our point estimate is smaller, the confidence intervals on our estimate suggest it is comparable to the effect Kilmer et al (2013) estimate for the South Dakota 24/7 Sobriety Program. However, there are differences in the evaluated outcome and the program itself that may make direct comparisons inappropriate. Prior analyses have not examined non-alcohol substance use in South Dakota.


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Funding was provided by National Institute of Justice, National Institute on Alcohol Abuse and Alcoholism (US) (Grant Nos. 2015-R2-CX-0016, R21AA022439). We thank presentation attendees at the American Society of Criminology, International Health Economics Association, and University of Pennsylvania Criminology Colloquium for valuable comments and suggestions. The manuscript was also improved by the feedback we received from the editors and two anonymous reviewers. We would also like to thank the Office of the North Dakota Attorney General and the alcohol testing companies (Alcohol Monitoring Systems and Intoximeters) for graciously providing data for this analysis. The views presented here represent only those of the authors.

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Correspondence to Greg Midgette.

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Midgette, G., Kilmer, B., Nicosia, N. et al. A Natural Experiment to Test the Effect of Sanction Certainty and Celerity on Substance-Impaired Driving: North Dakota’s 24/7 Sobriety Program. J Quant Criminol 37, 647–670 (2021).

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