DUI pre-arrest alcohol purchases: a survey of Sonoma County drunk drivers.

Based on a sample of 1,052 drunk drivers in northern California, less than 1% (0.80%) of those arrested for DUI had purchased and consumed alcohol prior to arrest from a convenience/gas store (gasmart). Data from both "on-sale" (on-premises consumption) and "off-sale" (off-premises consumption) alcohol outlets were compared. When off-sale outlets were compared only 2% of the DUI offenders had purchased and consumed alcohol from gasmarts prior to the arrest event. Gasmarts were the least frequent source of DUI-offender alcohol purchases. This report also describes the distribution of alcohol outlets for Sonoma and San Diego counties with respect to type of license and activity. Convenience stores that sold gas and alcohol concurrently were not overrepresented in either county.     

Characteristics of DUI recidivists: a 12-year follow-up study of first time DUI offenders

77 individuals convicted of a drinking and driving (DUI) offense were screened for recidivism approximately 12 years following their first offense. At the time of the initial DUI conviction, participants were administered the MAST and the MMPI-2. Participants' drinking history and driving history and arrest at the time of screening and at a 12-year follow-up were also reviewed. The results indicate that, among DUI recidivists, on average 6 years elapsed between their first and second DUI offenses. Driving history prior to the first DUI offense was predictive of later recidivism. The only significant finding from the MAST and MMPI results was that repeat offenders tended to have higher scores on the L and K validity scales of the MMPI. These results are discussed in the context of Jessor's Problem-Behavior Theory and as well their clinical implications for screening and treatment decisions involving first time DUI offenders.     

A five-year prospective study of diagnostic orphans for alcohol use disorders

OBJECTIVE: One consequence of the DSM-IV diagnostic system for substance abuse and dependence is that there are individuals who might endorse one or two of the criterion items for dependence but not meet criteria for abuse. These persons have been referred to as "diagnostic orphans." The aim of the analyses presented here is to further understanding about this potentially important group. METHOD: The DSM-IV categorical approach was used to determine alcohol-related diagnoses for 439 young adult men. Structured face-to-face follow-up interviews were administered 5 years later. RESULTS: At the beginning of the evaluation period, 14.6% (n = 64) of the men were alcohol dependent, 18.2% (n = 80) fulfilled criteria for alcohol abuse, 16.4% (n = 72) did not meet criteria for an alcohol use disorder but endorsed one or two of the dependence criteria and 50.8% (n = 223) reported none of the dependence items. At the initial interview, and again 5 years later, the diagnostic orphans reported alcohol and drug use histories that fell between the histories of those with dependence and those with no alcohol-related difficulties. The orphans were most similar to the men with abuse, although they had lower quantities and frequencies of alcohol use, endorsed fewer additional alcohol-related problems and reported less involvement with drugs compared with that group. CONCLUSIONS: Although the diagnostic orphans were more similar to the subjects with alcohol abuse than they were to those with dependence or no diagnosis, the data do not necessarily support combining the orphans with those with abuse. These diagnostic orphans do, however, constitute an important group that carries an enhanced risk for alcohol use disorders and should be closely followed.     

Comparative and joint prediction of DUI recidivism from alcohol ignition interlock and driver records

OBJECTIVE: This work was conducted to find practical predictors that anticipate which driving under the influence (DUI) offenders will continue to drink and drive after a period of alcohol ignition interlock-controlled driving ends. The interlock prevents impaired driving by requiring a low blood alcohol concentration (BAC) breath sample before allowing an engine to start. Each breath test is recorded. The study evaluated the interlock record as a predictor of future DUI offenses relative to driver records and self-report items. METHOD: Subjects were 2,273 DUI offenders in Alberta, Canada, who used an interlock to gain full reinstatement of driving privileges; for 2,134, the installed periods ranged from 5 to 30 months. A median of 8.1 breath tests was logged for each installed day; 9.9 tests were taken on each day of vehicle use (4.3 starts plus 5.6 running retests). Predictors of postinterlock repeat DUI were compared by sensitivity and survival analyses. RESULTS: Although 69% of all interlock users had at least one BAC test > or = .04% (a "fail" test) within the first 5 months, only 9% were reconvicted up to 4 years after interlock removal. Failed interlock tests proportional to all BAC tests taken was the best predictor of driver recidivism risk during the years following interlock removal. CONCLUSION: The interlock record provides new information, particularly about drivers with no prior DUI offenses. Prior moving violations and driving while suspended convictions, although better predictors than questionnaire data, were poorer than interlock records and prior DUI offenses. The alcohol interlock, already recognized as a useful control device, warrants attention for DUI prediction as well.     

The limited utility of BAC for identifying alcohol-related problems among DWI offenders.

To see if blood alcohol concentration (BAC) is a significant indicator of problem drinking or an alcohol-related diagnosis, the relationships between BAC at arrest for drinking and driving, typical drinking, alcohol-related problems, problem drinking and an alcohol abuse or dependence diagnosis were examined for 235 drinking and driving offenders referred for alcoholism evaluation. BAC and typical drinking correlated weakly and no significant relationship between alcohol-related problems and BAC was found. Further, no significant relationship was found between BAC and alcohol abuse or dependence diagnoses, or between problem drinking and BAC. These findings cast doubt on the usefulness of a single report of BAC for diagnostic and screening purposes.     

Typology of driving-under-the-influence (DUI) offenders revisited: Inclusion of DUI-specific attitudes

Objectives

Much work remains to improve rehabilitative interventions for driving-under-the-influence (DUI) offenders. There is heterogeneity of patterns of alcohol use, personality, and driving behaviour within DUI offenders, but little is known about how their appraisal of DUI differs. This study investigated within-offender variability in DUI-specific attitudinal variables.

Method

Convicted male DUI offenders (N = 219) living in greater Tokyo were interviewed. Cluster analysis was undertaken using age, psychological distress, personality trait, alcohol use, and attitudes towards DUI. Discriminant function analysis explored the relative explanatory power of the grouping variables.

Result

Many offenders reported current excessive alcohol consumption. About 26–36% of the participants were potentially alcohol-dependent based on screening instruments/biomarkers. Cluster analysis identified five subgroups. The biggest subgroup considered their DUI a singular mistake and reported strong self-efficacy for avoiding further DUI (clusters 1 and 2). A small subgroup manifested alcohol dependence, psychological distress, higher impulsivity, and lower self-efficacy for avoiding DUI (cluster 3). Another subgroup exhibited a tendency to rationalise DUI, higher likelihood of future DUI, and lower self-efficacy for avoiding DUI (cluster 4). Most participants in another small subgroup abstained from alcohol use temporarily after their convictions (cluster 5).

Conclusion

The majority of DUI offenders regarded their DUI conviction as an exceptional mishap, while they continued consuming hazardous amounts of alcohol. DUI-specific attitudinal variables, including DUI rationalisation and self-efficacy for avoiding future DUI incidents, constituted a distinct aspect of the problem, suggesting the need to address this issue in addition to the underlying alcohol use problem.     

DUI-arrest characteristics among white and Mexican-American DUI offenders mandated for treatment

OBJECTIVE: To report cross-ethnic differences among white and Mexican-American DUI offenders on the characteristics of an arrest (index) that brought subjects to treatment. METHOD: Subjects are 250 (223 male) whites and 249 (187 male) Mexican Americans consecutively admitted to five DUI offender programs in a Northern California county. Interviews averaged 1 hour in length and were conducted in the programs by trained interviewers. The response rate was 71% for whites and 84% for Mexican Americans. RESULTS: At the time of the arrest, Mexican Americans were driving cars older than those driven by whites. A higher proportion of Mexican Americans than whites reported having consumed 10 or more drinks before the arrest. The most frequent locale for drinking before the arrest was "home or friends' home" for Mexican Americans and a "bar/tavern/club" for whites. CONCLUSIONS: Cross-ethnic differences related to the circumstance of the arrest (car year) do not fully explain the higher rates of DUI arrest among Mexican Americans, compared with whites. Differences in drinking locale before arrest suggest that server intervention efforts may not be as effective in preventing DUI for Mexican Americans as they are for whites. Prevention interventions with Mexican Americans should center on the family, as a means to minimize drinking at home and decrease the large number of drinks consumed on a particular occasion by Mexican Americans.     

Impact of alcohol education and training on general practitioners' diagnostic and management skills: findings from a World Health Organization collaborative study.

OBJECTIVE: The potential of general practitioners (GPs) to reduce the prevalence of alcohol-related problems via alcohol intervention contrasts sharply with actual practice. One explanation for GPs' limited involvement in alcohol intervention is that they have had inadequate training or continuing medical education (CME) on alcohol-related issues. This study examined GPs' experience of alcohol-related CME and its possible relationship with attitudes and practice behavior regarding alcohol-related problems. METHOD: A questionnaire-based survey was returned by 2,139 GPs from 13 countries across Western and Eastern Europe. North America and Australasia. Diagnostic and management skills were assessed by responses to standardized case vignettes. RESULTS: The survey response rate was 54%. Approximately one third of GPs (32%) reported receiving no alcohol-related CME, while 8% could not remember whether or not they had received any such training or education. Of the remaining GPs (n = 1,217), 23% reported less than 4 hours (low levels) and 37% reported 4 or more hours (high levels) of alcohol-related CME. GPs who reported higher levels of alcohol-related CME were more likely to obtain information about alcohol, were more prepared to counsel problem drinkers and managed more patients for alcohol issues than did colleagues reporting lower levels of CME. Those with greater CME experience were also more confident about their ability to alleviate alcohol-related problems and reported more appropriate management strategies than did GPs with less CME experience. CONCLUSIONS: Greater exposure to alcohol-related CME appears to result in better diagnosis and more appropriate management of alcohol-related problems by GPs. Whether this is directly due to the CME itself or because GPs with greater interest in alcohol issues seek out such experience cannot be ascertained from the current study and requires further investigation.     

Variables associated with DUI offender status among whites and Mexican Americans

OBJECTIVE: Arrests of Hispanics have been found to be overrepresented among arrests for driving under the influence of alcohol (DUI) in California. Variables associated with offender status (first vs multiple) among Mexican-American and white DUI arrestees are analyzed to test the hypothesis that acculturation will be related to DUI among Mexican Americans while risk-taking dispositional variables will be related to DUI among whites. METHOD: A sample of 249 Mexican-American clients (with an oversampling of foreign-born) and 250 white clients were interviewed in all five DUI treatment programs in one northern California county. RESULTS: In univariate analysis, risk taking/impulsivity and sensation seeking were positively associated with multiple offender status among Mexican Americans, but not among whites. Multiple logistic regression found age as the only significant predictor of offender status in either ethnic group; however, path models found significant indirect effects on offender status of attitudes regarding DUI arrest through alcohol consumption, with those reporting having little chance of being arrested for DUI if stopped being less likely to report consuming five or more drinks at a sitting at least weekly, and with Mexican Americans being more likely than whites to believe they will not be arrested and to consider that DUI is not a problem. CONCLUSIONS: The data suggest that there are significant ethnic differences in attitudes and norms toward DUI that are related to frequency of drinking large amounts at one sitting, and future research is needed to determine how these variables along with dispositional and acculturation variables may be associated with DUI offender status.     

Telephone versus in-person interviews for alcohol use: results of the 2000 National Alcohol Survey

This study assesses differences in reports of alcohol use and alcohol-related harms using telephone and in-person interviews in a subsample of the 2000 National Alcohol Survey (NAS) (N = 411). Respondents were given a brief telephone interview which assessed their alcohol use and alcohol-related harms in the last 12 months followed by an in-person interview 2 months later that obtained the same data. Approximately 90% (n = 371) reported their drinking status consistently between interviews (277 current drinkers; 94 non-drinkers). Approximately 7% (n = 29) became current drinkers and 2.7% (n = 11) became non-drinkers at the second interview. The majority of respondents who changed their drinking status in either direction were low level drinkers. Using logistic regression modeling, no significant associations were found between demographic factors and consistency of reported drinking status. Further, there were no differences by mode for the two alcohol consumption measures (mean daily volume and mean number of days drank five or more drinks in the last 12 months) and alcohol-related harms in the last 12 months for current drinkers (n = 277). In conjunction with other mode studies, these findings support the use of telephone interviewing in large national surveys to obtain alcohol use and alcohol-related harms data.     

Alcohol criteria endorsement and psychiatric and drug use disorders among DUI offenders: Greater severity among women and multiple offenders

Purpose

Data from the Collaborative Study on the Genetics of Alcoholism (COGA), a high-risk family study of alcohol dependence, were used to examine differences in alcohol diagnostic criteria endorsement and psychiatric and drug use disorders by gender and by number of DUI offenses.

Results

Individuals with two or more DUIs exhibited greater severity of alcohol dependence than those with none or one DUI. This severity was characterized in three ways: (1) higher endorsement of alcohol diagnostic criterion items, with evidence of greater severity among women, (2) higher prevalence of co-occurring lifetime psychiatric disorders, and (3) higher rates of drug use and of dependence on cocaine, stimulants, and, for women only, marijuana and opiates.

Conclusions

By examining gradations of disorder within a combination of two high-risk indicators, DUI and family vulnerability, this study provides useful information for clinical research about individuals with chronic and severe alcohol problems. In addition, the observed gender differences in this high-risk sample will contribute to the literature on alcohol dependence among women at the more severe end of the dependence spectrum.     

广西柳州市酒后驾驶致严重道路交通事故的现况分析

目的 了解柳州市机动车驾驶员酒后驾驶行为在严重道路交通事故中的比例,为制定预防和控制酒后驾驶行为的政策和干预措施提供依据.方法 2007年1月1日至2007年6月30日,共发生严重道路交通事故100起,连续对所有导致至少有一人严重受伤或死亡的道路交通事故的机动车驾驶员(包括摩托车驾驶员)进行问卷调查和血液酒精含量测试.结果 酒后驾驶事故48起,事故主要发生在晚上21时至凌晨2时,共30起;以30～39岁为高发年龄,占46％;驾龄越长,酒后驾驶事故发生比例越高;非职业驾驶员发生酒后驾驶事故的比例高于职业驾驶员;摩托车驾驶员发生酒后驾驶事故的比例高于轿车驾驶员和客车驾驶员.结论 酒后驾驶是导致柳州市严重道路交通事故的最主要原因之一,必须采取广泛而有效的干预措施来降低酒后驾驶的发生率.     

Alcohol-related problems of future physicians prior to medical training

Time 1 data are presented from an ongoing longitudinal study of drinking patterns and problems of future physicians from medical school entrance through 2.5 years of training. The data in this report address the prevalence and psychosocial correlates of alcohol-related problems experienced prior to medical school training. A group of 167 students (91% of the cohort) was surveyed. Self-report questionnaires included: alcohol-related problems (the MAST), earlier parent-child relationships, personality characteristics (external locus of control, self-esteem, dependency, masculinity-femininity), life events, social supports, motivations for drinking and symptomatic distress. The male students manifested a higher mean level of alcohol problems, and the sexes differed at the trend level when the MAST was scored to distinguish "problem" from "nonproblem" drinkers (with 18.4% of the students reporting 5 or more problem points and 7.4% reporting 4 problem points). The significant correlates of alcohol problems included: perceived lack of earlier maternal affectivity (for men) and perceived lack of earlier paternal affectivity (for women), and lack of emotional support (for men). Moreover, escape motives for men were the motives most highly correlated with alcohol problems. Symptomatic distress (anxiety and hostility) was significantly correlated with alcohol-related problems in men but not women. Future reports will depict the psychosocial experiences and alcohol-related problems manifested by this cohort during medical training.     

Effects of an alcohol intervention on drinking among female college students with and without a recent history of sexual violence

Objective

Alcohol misuse among college students is a significant public health problem that can have negative long-term implications. One important correlate of problem drinking among college female populations is sexual violence. The current study investigated: (1) past year sexual violence and its association with alcohol consumption and related psychosocial variables (stress, coping, and mental health); and (2) whether the impact of an alcohol intervention was different for college women with a history of sexual violence compared to those without such a history.

Methods

Female undergraduate students (N = 351) who participated in the Brief Alcohol Screen in College Students (BASICS) completed web-based surveys measuring alcohol and drug use, psychosocial factors, and sexual violence at baseline and six-month follow-up.

Results

At baseline, women who experienced sexual violence reported less use of protective alcohol strategies, more positive coping skills, and more mental health symptoms. Following the intervention, alcohol consumption decreased significantly among the entire sample; however no significant differences in consumption were identified based on a history of sexual violence. Yet, compared to women not reporting sexual violence, women who reported recent sexual violence showed greater improvements in mental health outcomes (p < 0.05).

Conclusions

Findings suggest that brief alcohol interventions may have a differential impact on alcohol-related outcomes based on whether or not women have experienced recent sexual violence.     

Brand Preferences of Underage Drinkers Who Report Alcohol-Related Fights and Injuries

Background: A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. Objectives: We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. Methods: We recruited 1,031 self-reported drinkers (ages 13–20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Results: Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1–9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3–3.7; AOR: 1.8, 95% CI: 1.1–3.0 and 1.1–3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. Conclusions/Importance: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.     

Alcohol-related advice for Veterans Affairs primary care patients: Who gets it? Who gives it?

OBJECTIVE: Most patients who misuse alcohol do not receive alcohol counseling from their providers. This study evaluated primary care patient and provider characteristics associated with receipt of alcohol-related advice and whether patients were advised to drink less or to abstain. METHOD: Outpatients from seven Veterans Affairs (VA) general medicine clinics were eligible if they screened positive for alcohol misuse, completed the Alcohol Use Disorders Identification Test (AUDIT) and answered questions about alcohol-related treatment and advice. Hierarchical logistic regression was used to evaluate patient and provider characteristics associated with patient reports of alcohol-related advice from a primary care provider in the past year. RESULTS: Among 5191 patients with alcohol misuse in the past year, 1554 (30%) reported receiving alcohol-related advice from their primary care provider during that time. Of patients advised, 73% reported advice to abstain. The likelihood of reporting advice increased as AUDIT scores increased: from 13% of patients with AUDIT scores <8 to 71% of those with scores > or =20. After adjustment for important confounders, measures reflecting the severity of alcohol misuse were most strongly associated with receipt of alcohol-related advice. Adjusted analyses also revealed increased odds of receiving advice among patients who reported liver disease, hypertension, current smoking or continuity of care. No measured provider characteristic was associated with giving advice in the fully adjusted model. CONCLUSIONS: This multisite VA study found that most patients with alcohol misuse did not receive alcohol counseling from a primary care provider. Moreover, providers predominantly offered advice to abstain, and they appeared to focus on patients with the most severe problems due to drinking or medical contraindications to drinking.     

Construct validity of the MAST and AUDIT with multiple offender drunk drivers

The construct validity of the Michigan Alcoholism Screening Test (MAST) and the Alcohol Use Disorders Identification Test (AUDIT) in screening for current DSM-IV alcohol dependence disorders with persons convicted of multiple offenses of Driving Under the Influence (DUI) is evaluated. These tests were administered to 126 DUI offenders presenting for court-ordered inpatient treatment at an agency. DSM-IV alcohol disorders are evaluated for a representative subset of clients in this program using National Longitudinal Alcohol Epidemiologic Surveys' DSM-IV Alcohol Dependence Diagnostic Criteria and Associated Questionnaire Items. Both instruments exhibit acceptable internal consistency. The MAST and The AUDIT correlate moderately well with each other (r=0.617). The MAST correlates more highly (r=0.602) than the AUDIT (r=0.432) with DSM-IV. Future research should examine if the results reported here apply to other multiple offender DUI programs. It is recommended that such programs employing test instruments evaluate their construct validity in a similar method.     

Personality traits and behaviors of alcohol-impaired drivers: a comparison of first and multiple offenders.

Using an interview and questionnaire format, 358 driving under the influence of alcohol (DUI) first offenders and 141 DUI multiple offenders were compared on measures of personality traits, drinking behavior and problems, and driving behavior and history. In addition, official driving records for the two groups were compared. Results indicated that multiple offenders were significantly higher in hostility, sensation seeking, psychopathic deviance, mania, and depression than first offenders. Multiple offenders were significantly lower in emotional adjustment and assertiveness. Multiple offenders had significantly more nontraffic arrests, accidents, and traffic tickets than first offenders. They also consumed significantly more alcohol, evidenced more alcohol problems, and had higher BACs at the time of arrest than first offenders. Results are discussed in terms of general problem behavior and implications for intervention and treatment.     

Normative feedback for parents of college students: Piloting a parent based intervention to correct misperceptions of students' alcohol use and other parents' approval of drinking

Objective

Multi-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children's alcohol use decisions. However, parents tend to underestimate their own child's alcohol use and overestimate other similar parents' approval of student drinking. These misperceptions could have important implications for parents' own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college students.

Method

A sample of 144 parents of college students received web-based normative feedback about students' alcohol use and approval, as well as other same-college parents' alcohol approval. Parents completed measures of perceived student alcohol use, student alcohol approval, other-parent alcohol approval, and intentions to discuss alcohol use both pre- and post-normative feedback.

Results

Post-feedback, parents reported stronger intentions to talk to their student about alcohol, were less confident in their knowledge of their students' alcohol use, and believed that their student drank in greater quantity and more frequently than pre-feedback. Parents also perceived other parents to be less approving of alcohol use after viewing normative feedback.

Conclusions

These findings provide preliminary support for the use of web-based normative feedback for parents of college students. Given these promising results, further research developing and testing this approach merits attention.     

Alcohol Use and Drinking Motives Among Suddenly Bereaved College Students

Objective: Thousands of Americans grieve the sudden death of a loved one each year. These sudden deaths may be the result of violent deaths, as in the cases of homicide, suicide, or fatal accidents, or may occur as the result of natural causes such as heart attacks or strokes. Sudden loss survivors often experience negative mental health outcomes such as depression, prolonged grief disorder, and posttraumatic stress disorder. Survivors may also misuse alcohol for varied reasons after these losses, which can put them at risk for alcohol-related consequences. Thus, the purpose of this study was to explore associations between psychological distress and alcohol-related outcomes among young adults with a history of sudden loss. Methods: A sample of 659 young adults completed a series of self-report measures assessing loss history, psychosocial distress, perceived alcohol-related problems, and drinking motives. Results: Results showed that survivors of sudden, violent losses reported higher rates of past 30-day alcohol use than those who had lost a loved one to a sudden, natural loss or those who reported no loss history. Although there were no statistically significant differences in drinking motives between violent or natural loss survivors, more severe depression symptoms among bereaved individuals were associated with drinking to cope and to conform. Participants experiencing prolonged grief symptoms were also more likely to report drinking to conform. Conclusions: Bereavement-related distress may influence drinking motives among young adults with a history of sudden loss.