1 / 27

Long-Term Change Among Convicted Alcohol Impaired Drivers

Long-Term Change Among Convicted Alcohol Impaired Drivers. Sandra Lapham, MD MPH. Introduction. Study Purpose Background Study Design Measures Where we are as of July 31, 2006 Summary of Current Findings Discussion Questions?. Study Purpose.

koen
Download Presentation

Long-Term Change Among Convicted Alcohol Impaired Drivers

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Long-Term Change Among Convicted Alcohol Impaired Drivers Sandra Lapham, MD MPH

  2. Introduction • Study Purpose • Background • Study Design • Measures • Where we are as of July 31, 2006 • Summary of Current Findings • Discussion • Questions?

  3. Study Purpose • To measure the long-term progression of alcohol use and other psychiatric disorders in a cohort of convicted impaired drivers • psychological attributes • cognitive behavioral profiles • drinking styles and driving after drinking • To examine the natural history of alcohol and drug use disorders

  4. Background • Subjects were initially contacted between April 1989 and March 1992 following a conviction of first DWI and referral to the LCSP. • The second contact was five years later with a cohort of all female offenders within the initial timeframe, and a random cohort of males matched to the females on date of screening referral and ethnicity. • 2559 subjects were selected • 81% were located • 58 were deceased • 1396 were interviewed

  5. Long-Term Change (LTC)Study Design • 15-year follow-up to observe LTC in a cohort of individuals first interviewed 1989-1992 • Interview cohort (N=1396) • Anticipate 994 subjects will be contacted • Anticipate 835 will be interviewed

  6. Measures Interviews • Demographic/criminal history • Alcohol treatment • Health and Life Events • Composite International Diagnostic Interview (CIDI). • Lifetime Drinking History • Partner history • Driving Behaviors and Attitudes • Family history

  7. Measures Self Report • Lovelace Comprehensive Screening Instrument, measuring driving behaviors and attitudes • Leigh Expectancy Scale • Internal-External Scale (IE) • Rosenberg Self-Esteem Inventory • Beck Depression Inventory Record Data (Third Party) • DWI Citation Traffic File • Vehicle level accident file • Driver history file

  8. Where we are: July 31, 2006 • 1135 subjects reached their 15-year anniversary • 358 have completed F/U interviews • 6 unable to complete • 66 deceased • 78 refused interview • 627 in the locating/scheduling process • We are interviewing more women and Hispanics compared with target population

  9. Subject Characteristics* *Reached anniversary as of 7/31/06

  10. Demographics • Marital Status • No significant differences between gender or Race/Ethnicity by marital status. • Income • Females more likely to be in the lower two income levels (<12,000 and 12,000-23,999 in the past 12 months)

  11. Summary of Current FindingsAlcohol • Lifetime AUD Abuse: 46.6% Dependence: 53.4% No Dx: 10 subjects* * No gender or ethnic differences • Symptoms of AUD past year • 15.1%

  12. Summary of Current FindingsOther Drugs • Lifetime Drug Diagnosis Abuse: males 26.3%, females 15.4% Dependence: males 32.8%, females 27.1% No Diagnosis: males 40.9%, females 57.5%* *P < .005 • Symptoms of DUD past year • 11.5% overall

  13. Co-morbid Disorders • Lifetime Non-AoD Diagnosis 55.6% • Symptoms in past year 36.6% total, 65.8% of those w/Dx • Females (lifetime and recent) and Other ethnicities (lifetime) report higher rates

  14. Rates of Other Disorders • PTSD (18.5%) • Phobia, natural environment (12.3%) • Phobia, social (11.4%)

  15. Summary: Co-occurring behavioral & mental health issues • Males more likely to be diagnosed with other drug dependence or abuse • Females more likely to be diagnosed with a mental health disorder and to report recent symptoms of a mental health disorder.

  16. Driving Outcomes • Significant differences between gender and race/ethnicity by charged with DUI in past 10 years: Males and American Indians report more DUI charges past 10 years • Yet no significant differences between gender and race/ethnicity by self-reported drinking and driving (12.5%)

  17. Alcohol Use • Av. Age Drinking/Regular Basis Abuse: 19.9 years Dependence: 18.1 years* • Alcohol use past year regular: 58.9% irregular: 21.1% abstain: 20.0% *P < .004, t test

  18. Drinking Patterns • Females more likely to report starting regular drinking at a later age than males and more likely to report fewer years of regular drinking • Those in the “Other” race/ethnicity category are more likely to report starting regular drinking at a later age. • Non-Hispanic Whites more likely to report more years of drinking prior to DUI screening.

  19. Alcohol Treatment No significant Gender or Race/Ethnicity differences, past 10 years: • Outpatient treatment for AUD • ED treatment for AUD • Alcohol counseling • Worked AA steps • Been to a detoxification facility

  20. Attitudes related to Alcohol • Females more likely to believe that 6 drinks a day will be very harmful to one’s health • Males more likely to have their desire to drink strongly affected by the statement “I feel like partying” • Non-Hispanic Whites and American Indians more likely to report a likely outcome of drinking would be “I enjoy the buzz” than White Hispanic. • Non-Hispanic Whites less likely to think it is important to change their drinking or to report being ready to change their drinking.

  21. Lifestyles:Daily Servings of Fruit/Vegetables

  22. Lifestyles: Exercise

  23. General Health • In the past 30 days, females more likely to report 16-30 days of bad health Vs. 0 days., and more likely to report 1-15 days of restricted activities due to health problems Vs. 0 days. • Females more likely to report any pain versus no pain in the past 4 weeks. • Females more likely to have had a check-up in the past year versus 5 years ago. • Males more likely to report hypertension. • Females more likely to be in the BMI obese Vs. overweight category.

  24. General Health • Race/Ethnicity Differences • White, not Hispanic, more likely to report excellent to very good health than white Hispanics or others. • Native Americans more likely than the “Other” race/ethnicity group to be in the BMI obese Vs. normal category

  25. Alcohol Diagnostic Groups • Group 1: Symptoms of AUD in the past 12 months • Group 2: Symptoms in the past 2-5 years • Group 3: Symptoms > 5 years ago

  26. Challenges Locating subjects is difficult There is a relatively high refusal rate Death certificates expensive

  27. And progress continues… Any questions or comments?

More Related