Nancy Nicosia

Alcohol is the third-leading cause of preventable death in the US, with alcohol-impaired driving alone claiming 11 654 lives in 2020—a 14% increase over the previous year.¹ To address this problem, some jurisdictions are using 24/7 sobriety programs, which combine alcohol abstinence orders with frequent alcohol testing (eg, twice-daily breathalyzers, monitoring bracelets) and swift, certain, and moderate sanctions for noncompliance (typically 1 to 2 nights in jail) to reduce alcohol consumption among those arrested or convicted for alcohol-involved offenses. Individual-level analyses of South Dakota’s 24/7 sobriety program demonstrate lower risk of rearrest among participants relative to nonparticipants.² While county-level analyses also document a negative association with mortality,³ this study, with instrumental variables analysis, was conducted to assess the association between 24/7 sobriety and time-to-mortality using individual-level data.