A percentage of people who are arrested for drunk driving are dealing with issues other than alcohol, such as drug use and mental health problems. To prevent this group of drivers from becoming repeat offenders, programs are needed that address their issues specifically, researchers say.
Submitting offenders with psychological issues and drug addictions to the usual "DUI School" educational program is probably not going to work, experts claim.
Most first-time drunk driving offenders have high rates of other substance abuse as well as other psychiatric disorders, according to a Yale University School of Medicine study. These offenders may need enhanced intervention programs that go beyond the conventional alcohol-related programs, the researchers say.
Drug Use and Psychiatric Problems
"While other studies have examined symptoms of depression as a predictor of change during interventions for DUI offenders, ours is the first to examine formal diagnoses of drug use and other psychiatric problems," said Rebekka S. Palmer, corresponding author for the study.
"We found that 42 percent of first-time DUI offenders reported a lifetime history of drug abuse or dependence," Palmer said. "Marijuana abuse or dependence was the most prevalent, followed by hallucinogen abuse or dependence, and then cocaine abuse or dependence. Approximately 30 percent of the participants also indicated a lifetime history of anxiety or mood disorder. Social phobia was the most frequent anxiety diagnosis, and major depression was the most common mood disorder."
Drivers With Other Disorders
During the study the 290 participants did significantly reduce their drinking and alcohol-related problems, but some subgroups were less responsive, according to co-author Mary E. Larimer.
"The programs we use to treat DUI offenders to help them stop using alcohol are less effective in the long run for those who have a psychiatric disorder or a drug-use disorder than they are for those who are only experiencing problems with their drinking," said Larimer. "This means those who have another disorder in addition to their drinking problems are at greater risk to drive under the influence of alcohol again in the future, or to be involved in other accidents or harmful situations related to their drinking."
DUI Treatment Should Be Extended
The authors believe current DUI treatment approaches could be modified, enhanced or extended to meet the needs of these subgroups.
"For those with psychiatric disorders," said Larimer, "it may be that treatments need to be longer and more intensive, and/or have specific additional components designed to improve coping resources, teach skills for mood management to counteract the tendency to use alcohol as a way to cope with mood, and help these individuals improve their confidence that they can change.
"This study indicates these individuals are actually more willing and ready to change than those without other psychiatric diagnoses, but they are not sure how and have low confidence in their ability to change, which is reflected in their poorer outcomes."
Targeting Relapse Situations
"For those with other substance disorders, results suggest the need to extend the aftercare components of treatment," Larimer said. "Perhaps clinicians can target additional situations associated with relapse to other drugs that might not be covered in alcohol-focused treatment, and address the ways in which alcohol -- and other drug -- use are related for these individuals."
"Those seeking treatment for multiple disorders might consider investigating the extent to which treatments address issues beyond the cessation of alcohol use alone, and also the extent to which follow-up care is available and easily accessible to meet their needs," she said. "Also, moving these programs into the prevention arena, to reduce rates of DUI prior to citation and conviction, is an urgent public health priority. This is not a simple problem, and one-size-fits-all treatments are not likely to be the solution."
Source: Palmer RS, et al. "Concurrent and Predictive Validity of Drug Use and Psychiatric Diagnosis Among First-Time DWI Offenders." Alcoholism: Clinical & Experimental Research DOI: 10.1111/j.1530-0277.2007.00346.x
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