Functioning of alcohol use disorder criteria among men and women with arrests for driving under the influence of alcohol

Background: Many states require screening of individuals arrested for driving under the influence (DUI) of alcohol to determine recidivism risk and the need for treatment based on severity of alcohol problems. Several screening instruments use DSM‐IV criteria for alcohol abuse and dependence to assess alcohol problems in this population, but whether they adequately measure alcohol problems in individuals with DUIs has not been examined. In addition, gender differences in DUI samples suggest that female offenders have more severe alcohol problems than male offenders. The current study examines differences in alcohol criteria functioning by DUI history and gender using an item response theory (IRT) approach. Methods: Data from diagnostic interviews with 8,605 participants in the Collaborative Study on the Genetics of Alcoholism, including 1,655 who ever reported a DUI arrest (20% women), were used to examine differences in alcohol criteria functioning between men and women with and without DUIs. The factor underlying item response was conceptualized as unidimensional, representing alcohol problem severity. Results: Social/interpersonal problems, larger/longer, and inability/persistent desire to quit displayed greater discrimination of IRT‐defined alcohol problem severity among individuals with DUIs than those without. Irrespective of DUI status, women had a higher threshold than men for time spent drinking or recovering. Women without DUIs had a higher threshold than similar men for social/interpersonal problems. Taken as a whole, the criteria yielded similar amounts of information in all groups. Conclusions: DSM‐IV criteria for alcohol abuse and dependence adequately detect alcohol problem severity in individuals with DUIs, and some are better at detecting severity in this particularly high‐risk group than in individuals without DUIs. However, the criteria as a whole are equally effective in measuring alcohol problem severity among individuals with and without DUIs and may be used with confidence in screening DUI offenders.     

Long-Term Change in Underage Drinking and Impaired Driving After the Establishment of Drinking Age Laws in New York State

This study depicts the long-term change in youths' alcohol use and impaired driving behaviors associated with the establishment of the drinking age laws. Five telephone surveys were conducted with youths aged 16 to 24 in 10 sampled New York State counties in 1982, 1983, 1985, 1986, and 1996. Analysis of the self-reported data showed that, 10 years after the enactment of the 21 drinking age law, alcohol use among la-, 19-, and 20-year-olds decreased by up to 58%. Alcohol purchase rates of 19- and 20-year-olds were reduced by ∼70% from 1985 to 1996. Although impaired driving rates declined over the survey years for each age group, ∼25% of all underage respondents in 1996 reported that they had ridden in a vehicle with an impaired driver. Findings from this research indicate that alcohol purchase, alcohol use, and impaired driving have declined among the targeted youth groups as a result of the 21 drinking age law. However, continued efforts need to focus on both underage drinking and impaired driving/riding with impaired drivers, because they remain serious public health risks among the youth population.     

Brief Motivational Interviewing for DWI Recidivists Who Abuse Alcohol and Are Not Participating in DWI Intervention: A Randomized Controlled Trial

Background: Driving while impaired (DWI) recidivists with unresolved alcohol use problems pose an ongoing risk for traffic safety. Following conviction, many do not participate in mandated alcohol evaluation and intervention programs, or continue to drink problematically after being relicensed. This study investigated if, in DWI recidivists with alcohol problems and not currently involved in DWI intervention, Brief Motivational Interviewing (BMI) produced greater reductions in risky drinking at 6‐ and 12‐month follow‐up compared to an information‐advice control condition. Additional analyses explored whether BMI was associated with greater readiness to change, subsequent substance abuse treatment service utilization, and satisfaction compared to the control condition. Methods: Male and female recidivists with drinking problems and not currently engaged in DWI intervention were recruited, evaluated, and then randomly assigned to receive 1 of 2 manualized interventions: 30‐minute BMI session or information‐advice. Participants, interviewers, researchers, and statisticians were blind to assignment. Outcomes were changed in: percent of risky drinking days (i.e., ≥3 standard drinks/d for males; ≥2 for females) in the previous 6 months derived from the Timeline Followback, biomarkers of alcohol abuse (GGT, AST, ALT, MCV) by blood assay, and alcohol abuse‐related behaviors using the MMPI‐Mac scale. Data from the Readiness to Change Questionnaire, a substance abuse service utilization questionnaire, and the Client Satisfaction Scale were also collected. Results: Analyses revealed significant declines in risky drinking with both interventions. BMI (n = 92) resulted in a 25% reduction in risky drinking days at 12‐month follow‐up, which compared to the control intervention (n = 92) represented a significant decline from 6‐month levels. Exposure to BMI also produced significantly greater improvement at 6‐month follow‐up in a biomarker of alcohol abuse and a behavioral measure related to recidivism risk. Exploration of readiness to change, substance abuse service utilization, and satisfaction with intervention indicated a perception of BMI being more useful in coping with problems. Conclusions: Brief MI approaches warrant further implementation and effectiveness research as an opportunistic DWI intervention strategy to reduce risks associated with alcohol use outside of clinical and DWI relicensing settings.