The impact of a novel educational curriculum for first-time DUI offenders on intermediate outcomes relevant to DUI recidivism

Association of habitual alcohol use on risk-taking behaviors while using a car: The Korean National Health and Nutrition Examination Survey 2009-2013

BACKGROUND

Using the Alcohol Use Disorders Identification Test-Korean revised version (AUDIT-KR), we examined the association between habitual alcohol use and risk-taking behaviors among car users.

METHODS

We used the data of 15,043 car users aged 20 years or older from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2009 and 2013. Multivariable logistic regression analysis was used to investigate the associations between alcohol use and risk-taking behaviors (i.e., driving under the influence of alcohol, riding in a car being driven under the influence, not wearing a seat belt while driving, not wearing a seat belt in the passenger seat), while adjusting for individual-level covariates.

RESULTS

Compared to low-risk drinkers, high-risk drinkers (adjusted odds ratio [Adj.OR] 2.18, 95 % CI 1.96-2.42) and intermediate-risk drinkers (Adj.OR 1.39, 95 % CI 1.26-1.54) had higher odds of risk-taking behaviors while using a car. Stratifying by sociodemographic variables (i.e., sex, age, and region) led to differences in the relationship between alcohol-drinking level and risk-taking behaviors. Furthermore, alcohol-drinking level had significant positive associations with most of risk-taking behaviors, especially driving under the influence of alcohol and using a car with a drunken driver.

CONCLUSION

Car users with high levels of alcohol consumption are more likely to be involved in risk-taking behaviors, especially in driving under the influence of alcohol. While causal relations cannot be established due to the nature of the cross-sectional design, it is possible that individuals' habitual alcohol consumption level can influence their risk-taking behaviors while using a car.

Predictive factors associated with driving under the influence among Brazilian drug-using drivers

The incidence of driving under the influence of psychoactive substances (DUI) and its recidivism can be curtailed by the proper identification of specific and predictive characteristics among drug users. In this sense, interpersonal violence (IV), psychiatric comorbidity and impulsivity seem to play an important role in DUI engagement according to previous studies. There are, however, limited data originated from low and middle income countries. In the present study, drug-using Brazilian drivers reporting DUI (n = 75) presented a higher prevalence of bipolar disorders (BD; DUI: 8% vs. non-DUI: 0%, p < 0.001), lower prevalence of obsessive-compulsive disorder (OCD; DUI: 0% vs. non-DUI: 12.6%, p < 0.001), and higher prevalence of childhood trauma (DUI: 65.3% vs. non-DUI: 46.8%, p = 0.022) than those not reporting DUI (n = 79). The evaluation of impulsivity though the Barratt Impulsivity Scale, which give impulsivity scores ranging from 30 to 120, showed higher impulsivity scores in the DUI group (80.4 ± 8) than in the non-DUI group (77.2 ± 10, p = 0.045). In general, subjects were young adults (mean age of 36 ± 9 years), Caucasians (58.4%), not married (61.0%), and with elementary schooling (40.3%) with no significant differences in demographic characteristics between drivers with and without DUI behavior. A multiple Poisson regression model showed that individuals reporting IV as perpetrators and history of childhood trauma were more likely to report DUI (PR: 1.66, 95%CI 1.22-2.7; PR: 1.57, 95%CI 1.02-2.42, respectively). The overlapping of violent situations (childhood trauma, IV and DUI) in some individuals presented here corroborates literature data suggesting that DUI can be an externalizing expression of a range of risky behavior, such as impulsiveness and aggressiveness. Moreover, while BD and higher impulsivity scores seem to act as risk factors for DUI, OCD was shown as a protective factor. These results corroborate the hypothesis that individuals with high risk for DUI could probably be identified by multidimensional assessment of cognitive, risky taking, and personality traits, which perhaps could facilitate the development of focused interventions.

Drinking and driving relapse: Data from BAC and MMPI-2

Road traffic injuries are the ninth cause of death across all age groups, globally (WHO, 2015). Many road traffic crashes are caused by Driving Under the Influence (DUI) of alcohol by persons who have previously had their license suspended for the same reason. The aim of this study was to identify specific risk factors and personality characteristics in repeat offenders. The sample was comprised of 260 subjects who were not repeat DUI offenders (DUI-NR), but had a single license suspension between 2010 and 2011; and 97 repeat offenders who received at least two DUI convictions within a period of 5 years. At the time of their first driving license suspension, participants provided their blood alcohol content (BAC) and completed a valid MMPI-2 test. ANOVA and MANOVAs were performed to determine whether there were significant differences in BAC and MMPI-2 profiles between DUI-NR and DUI-R participants and a logistic regression was run to identify whether BAC at the time of the first suspension and specific personality features could predict recidivism. A two-step cluster analysis was run to identify recidivist typologies. Results showed that, relative to DUI-NR participants, DUI-R participants had higher BAC at the time of their first conviction and more problematic MMPI-2 profiles, despite the presence of social desirability responding. The best predictors of recidivism were BAC and the scales of Lie (L), Correction (K), Psychopathic Deviate (4-Pd), Hypomania (9-Ma), and Low Self-Esteem (LSE). Two-step cluster analyses identified two recidivist profiles, according to 32 selected MMPI-2 validity, clinical, content, supplementary, and PSY-5 scales. Comparisons with previous research are discussed and ideas for further study are generated.

Operating under the influence: Three year recidivism rates for motivation-enhancing versus standard care programs

Operating a motor vehicle under the influence of alcohol (OUI) is an international problem. In the United States, one intervention strategy is to require offenders to attend group-delivered interventions. We compared three year rearrest rates among 12,267 individuals in Maine receiving either a motivation-enhancing (ME) program, Prime For Life(®), or historical standard care (SC) programs. We created two cohorts, one when Maine used SC (9/1/1999-8/31/2000) and one after the ME program was implemented (9/1/2002-8/31/2003). Adjusted for control variables, rearrest rates among people not completing an assigned program did not differ for the ME versus SC cohorts (12.1% and 11.6%, respectively; OR=1.05, ns). In contrast, ME compared to SC program completers had lower rearrest rates (7.4% versus 9.9%, OR=0.73, p<.05). The same pattern occurred for people required to take these programs plus substance use treatment (12.1% versus 14.7%, OR=0.82, p<.01). For those rearrested, time to rearrest did not differ between ME and SC cohorts. Among those required to have substance abuse treatment, ME and SC arrest rates did not differ for younger individuals; otherwise, the ME cohort's lower rearrest rates occurred across gender, age, having a previous OUI, and having completed a previous intervention program.

DUI offenders' experience with an ignition interlock program: comparing those who have and have not adapted from their primary drinking location

OBJECTIVE

The purpose of this study was to compare driving under the influence (DUI) offenders on an alcohol ignition interlock program who had or had not changed their primary drinking context from a bar/restaurant where they might be required to drive after drinking before the interlock was installed to drinking at home where driving would not be likely to be required following interlock installation.

METHODS

A total of 171 DUI offenders who were on an ignition interlock program completed a web-based survey. All of these offenders reported that they drank primarily in a bar/restaurant before the interlock was installed. These offenders were classified into 2 groups: adapters who said they currently drink at home and nonadapters who said they still drink in a bar/restaurant. Measures were made of their reported drinking, driving patterns, perceptions of the likely outcomes of being on the interlock, perceived effectiveness of various prevention strategies, and demographic characteristics. Chi-square and t-test analyses were used to compare these 2 groups.

RESULTS

Adapters and nonadapters did not differ with regard to any of the demographic characteristics, whether they were a first-time DUI offender, the length of time in the interlock program, number of lockouts (being blocked from starting their cars) they had experienced, miles driven per week, or current driving patterns since being on the interlock program. Adapters were more likely to report changing their drinking plans and habits. Currently they reported fewer drinks per occasion than nonadapters. They were more likely to report reducing the amount they drink, solo drinking or only drinking with a spouse/significant other, and changing their drinking plans and habits. They were also more likely to say that the interlock reminded them to limit their drinking after it is removed and that it might have longer term benefits in preventing future DUIs. They were also more receptive to interventions that might help them separate their drinking from their driving.

CONCLUSIONS

Interlock clients who report that they have altered their drinking context and a willingness to receive programs that help them separate their drinking from their driving may be more receptive to and benefit from ignition interlock programs.

Potential determinants of drink driving in young adults

OBJECTIVE

The main purposes of this study were to examine the usefulness of the variables of the theory of planned behavior (viz. attitudes, social norms, and self-efficacy) and to explore the relationship between optimism bias and drink driving in young adults. In addition, we explored gender differences in drink driving with provision for the effect of variables such as driving frequency and alcohol consumption.

METHODS

Data were collected via a questionnaire administered to 274 drivers (59.9% females) aged 18-30 years (24.36 ± 2.96).

RESULTS

The results obtained with provision for driving frequency revealed substantial differences in driving behaviors between genders. Thus, males were more prone to drink driving, perceived less disapproval by their significant others (parents and peers), and felt less able to avoid drinking-and-driving situations. In addition, they self-reported more frequent alcohol consumption and driving under the influence. The results also confirm the significance of peers' subjective norms and attitudes to drink driving in males. Overconfidence in their own driving skills for driving drunk and perceived behavioral control were found to be significant predictors for drink driving in females. Optimism bias also played a slightly significant role in predicting drink driving but only in females.

CONCLUSIONS

The important practical implications of these results with a view to designing effective interventions to prevent the risks associated with drink driving in the young population are discussed. Interventions should focus on young people's perceptions of group norms and promoting cautionary driving choices and alternatives to drink driving.

Sensation seeking and drunk driving: the mediational role of social norms and self-efficacy

The aim of this work was to examine the role of sensation seeking in drunk driving by youths, and the potential mediational effect of social, cognitive and emotional variables on their relationship. To this end, a survey was conducted on 274 drivers (164 females and 110 males) aged 24.36±2.96 years (range 18-30 years). The results obtained confirm the significance of sensation seeking to drunk driving by youths and the mediating role of biased self-efficacy perceptions in their relationship. The important practical implications of this finding on the development of effective interventions to prevent the risks of drunk driving in youths are discussed.

Characteristics of DUI offenders with a high versus low perceived risk of arrest

OBJECTIVE

To compare offenders with high versus low perceptions of risk for being stopped by police for drinking and driving using measures of beliefs, behaviors, social context of drinking, and perceived influence from a significant other in their social network.

METHOD

Telephone interviews were conducted with 161 individuals who received a first-time driving under the influence (DUI) citation in Maryland. They were divided into 2 groups: those who felt that it was almost certain or very likely that they would be stopped by the police if they drove after having too much to drink (n = 56) and those who felt that it was only somewhat likely or unlikely (n = 105).

RESULTS

The 2 groups did not differ in terms of age, gender, race/ethnicity, education, employment, or marital status. Offenders with a low perceived risk of being stopped were less likely to believe that they would be convicted if they were stopped and arrested. They were more likely to report having an encounter with an aggressive driver, running through a stop sign or traffic light, drinking in a context of social facilitation, knowing someone in their social network who had received a DUI citation, and having a member of their social network suggest that they had had too much to drink and could not drive safely.

CONCLUSIONS

The social context of drinking and the relationship they have to their social network have important implications for influencing first DUI offenders and preventing them from recidivating.

Towards a national model for managing impaired driving offenders

AIMS

To describe a proposed national model for controlling the risk presented by offenders convicted of driving while impaired (DWI) and promoting behavioral change to reduce future recidivism.

SETTING

Traditional methods of controlling the risk they present to the driving public are not adequate, as indicated by the fact that approximately 1000 people are killed each year-in alcohol-related crashes involving drivers convicted of DWI in the previous three years. However, stimulated by the success of special drug courts for substance abusers and new technological methods for monitoring drug and alcohol use, new criminal justice programs for managing impaired driving offenders are emerging.

INTERVENTION

A national model for a comprehensive system applicable to both drug and alcohol impaired drivers is proposed. The program focuses on monitoring offender drinking or the offender driving employing vehicle interlocks with swift, sure but moderate penalties for non-compliance in which the ultimate sanction is based on offender performance in meeting monitoring requirements.

FINDINGS

Several new court programs, such as the 24/7 Sobriety Project in South Dakota and North Dakota and the Hawaii's Opportunity Probation with Enforcement (HOPE) Project, which feature alcohol/drug consumption monitoring, have produced evidence that indicates even dependent drinkers can conform to abstinence monitoring requirements and avoid the short-term jail consequence for failure.

CONCLUSIONS

Based on the apparent success of emerging court monitoring systems, it appears that the cost of incarcerating driving-while-impaired offenders can be minimized by employing low-cost community correction programs paid for by the offender.

Cooperation between police and social treatment services offering treatment to drink and drug drivers--experience in Sweden

OBJECTIVE

To describe and analyze a measure that has been introduced in Sweden with the objective of quickly offering treatment for the alcohol or drug problems suspected drink or drug drivers may have. The goal of the measure is that every suspected drink or drug driver shall, as soon as apprehended by the police, be offered contact with the social services or the dependency care and treatment service, which can offer a consultation and, if needed, suitable treatment.

METHOD

Interviews and questionnaire surveys, as well as forms that describe the treatment received by each individual case.

RESULTS

About 20 percent of all those who receive the offer from the police accept contact with the social services or the care and treatment service, and approximately 40 percent of these also attend the consultation. There is a favorable fundamental attitude to the method among the participating authorities. However, some shortcomings in application are revealed. One example concerns drug drivers who are offered contact with the social services or the care and treatment service to a considerably lesser extent than drink drivers. Another neglected group are the people who are at first suspected of drink driving but are later found to have an alcohol concentration below the legal limit. Compared with those who have an alcohol concentration above the legal limit, this group is offered contact to a lesser extent and also have a lower propensity to accept the offer.

CONCLUSIONS

The results indicate a strong support for the method from involved authorities, but participation could be improved by giving more attention to neglected groups.

Avoiding DWI Among Bar-room Drinkers: Strategies and Predictors

We examined the prevalence and predictors of 11strategies to avoid driving when feeling intoxicated among 561 bar-room patrons in two medium-sized Maryland communities. Logistic regression analyses identified demographic, behavioral, and attitudinal predictors of avoidance strategies and interactions among predictors. Overall, 89% reported one or more DWI avoidance actions in the past year, and 38% reported driving intoxicated during that time. Average frequencies of avoidance behavior and intoxicated driving increased significantly as drinking level increased. However, the higher the drinking level, the smaller the ratio of avoidance actions to DWI experiences, highlighting the vulnerability of heavy drinkers who had driven intoxicated.

Using a sober driver or one who allegedly drank less than the respondent were the most popular and frequent strategies, but paying for a cab, walking, and using a bus or free cab were relatively unpopular. Higher drinking levels predicted significantly higher odds of using avoidance approaches, as did intoxicated driving. Confidence in driving safely when intoxicated was positively related to drinking level and intoxicated driving, but it tended to predict lower odds of avoidance actions. Similarly, marital status, age, gender, and location influenced the odds of avoidance behaviors. Interventions should be strategically tailored to exploit or counter drinker predilections among avoidance options.

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., > or =3 standard drinks/d for males; > or =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.

Preventing alcohol-related convictions: the effect of a novel curriculum for first-time offenders on DUI recidivism

OBJECTIVE

To determine whether DUI offenders can better avoid future drinking and driving by controlling their vehicle usage rather than by controlling their drinking.

METHODS

Using a randomized experimental post-test only design, 9,571 first-time DUI offenders were randomly assigned to receive one of two 12-hour educational programs: a traditional DUI curriculum or the PARC (Preventing Alcohol-Related Convictions) curriculum, which uses a novel theoretical approach to preventing DUI recidivism. Whereas traditional programs focus on participants controlling their drinking to avoid future drinking and driving, the PARC curriculum focuses on participants controlling their driving. Instead of trying to control alcohol consumption after driving to a drinking venue (previously found to be a flawed strategy), PARC teaches students to make a decision before leaving home not to drive to a drinking event, thus greatly limiting the possibility of drinking and driving. Driving records were obtained from the Florida Department of Motor Vehicles using driver's license numbers to assess DUI recidivism rates among the students in the PARC and Traditional curricula for the first year following program participation and again at 2 years post-intervention.

RESULTS

Binary logistic regression analyses revealed that offenders receiving the PARC curriculum exhibited significantly lower 1-year and 2-year recidivism rates than those receiving the Traditional curriculum. The effect was consistent across two different measures of recidivism, and across gender, race, ethnicity, and location.

CONCLUSION

Results suggest that the PARC educational approach may be more effective than the traditional approach in reducing DUI recidivism.