Risk of alcohol-impaired driving recidivism among first offenders and multiple offenders.

OBJECTIVES: We sought to determine the statewide impact of having prior alcohol-impaired driving violations of any type on the rate of first occurrence or recidivism among drivers with 0, 1, 2, or 3 or more prior violations in Maryland. METHODS: We analyzed more than 100 million driver records from 1973 to 2004 and classified all Maryland drivers into 4 groups: those with 0, 1, 2, or 3 or more prior violations. The violation rates for approximately 21 million drivers in these 4 groups were compared for the study period 1999 to 2004. RESULTS: On average, there were 3.4, 24.3, 35.9, and 50.8 violations per 1000 drivers a year among those with 0, 1, 2, or 3 or more priors, respectively. The relative risks for men compared with women among these groups of drivers were 3.8, 1.2, 1.0, and 1.0, respectively. CONCLUSIONS: The recidivism rate among first offenders more closely resembles that of second offenders than of nonoffenders. Men and women are at equal risk of recidivating once they have had a first violation documented. Any alcohol-impaired driving violation, not just convictions, is a marker for future recidivism.