Correlates of Breath Alcohol Concentration Among Driving Under the Influence Program Clients in Southern California

Abstract

Understanding factors correlated with breath alcohol concentration (BrAC) at time of arrest for driving under the influence (DUI) may lead to informed rehabilitation programs. This study describes correlations between BrAC at time of arrest and sociodemographic, mental, and physical health, and alcohol-related characteristics among clients in a large California DUI Program. Client reported data (n = 17,282) were collected at an intake from 2009 to 2014. BrACs ranged from 0.083% to 0.390%, with an average of 0.159% (SD = 0.051), almost twice the legal limit in the state. Approximately 10.6% of the variance in BrAC was explained by 11 significant correlates. Two sociodemographic factors (age and race/ethnicity) as well as several alcohol-related characteristics were related to higher BrAC levels, whereas comorbid mental and physical health factors played less of a role. Factors associated with BrAC are complex and warrant further investigation to identify causality and inform future interventions.

Keywords

BrAC blood alcohol concentration drunk driving DUI MAST CAGE alcohol use disorder

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References

Ani

Bazargan

Bazargan-Hejazi

Andersen

R. M.

Hindman

D. W.

Baker

R. S.

(2008). Correlates of self-diagnosis of chronic medical and mental health conditions in under-served African American and Latino populations. Ethnicity & Disease, 18, 105-111.

Boden

J. M.

Fergusson

D. M.

(2011). Alcohol and depression. Addiction, 106, 906-914. doi:10.1111/j.1360-0443.2010.03351.x

Boschloo

Vogelzangs

van den Brink

Smit

J. H.

Veltman

D. J.

Beekman

A. T. F.

Penninx

B. W. J. H

. (2012). Alcohol use disorders and the course of depressive and anxiety disorders. British Journal of Psychiatry, 200, 476-484. doi:10.1192/bjp.bp.111.097550

Bush

Kivlahan

D. R.

McDonell

M. B.

Fihn

S. D.

Bradley

K. A.

(1998). The AUDIT Alcohol Consumption Questions (AUDIT-C)—An effective brief screening test for problem drinking. Archives of Internal Medicine, 158, 1789-1795.

Caetano

McGrath

(2005). Driving under the influence (DUI) among U.S. ethnic groups. Accident Analysis & Prevention, 37, 217-224.

California Office of Traffic Safety. (2016). 2016 annual report. Retrieved from https://www.ots.ca.gov/Media_and_Research/Publications_and_Reports/hsp16/2016_Annual_Report.pdf

Centers for Disease Control and Prevention. (2016). Motor vehicle crash deaths (Vital Signs). Retrieved from https://www.cdc.gov/vitalsigns/motor-vehicle-safety/index.html

Cohen

(1988). Statistical power analysis for the behavioral sciences. New York, NY: Routledge.

Crum

R. M.

Mojtabai

Lazareck

Bolton

J. M.

Robinson

Sareen

. . . Storr

C. L.

(2013). A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence. JAMA Psychiatry, 70, 718-726.

10.

Driessen

Schulte

Luedecke

Schaefer

Sutmann

Ohlmeier

. . . Havemann-Reinicke

(2008). Trauma and PTSD in patients with alcohol, drug, or dual dependence: A multi-center study. Alcoholism: Clinical and Experimental Research, 32, 481-488.

11.

Ewing

J. A.

(1984). Detecting alcoholism: The CAGE Questionnaire. Journal of the American Medical Association, 252, 1905-1907.

12.

Fergusson

D. M.

Boden

J. M.

Horwood

L. J.

(2009). Tests of causal links between alcohol abuse or dependence and major depression. Archives of General Psychiatry, 66, 260-266. doi:10.1001/archgenpsychiatry.2008.543

13.

Frank

J. W.

Moore

R. S.

Ames

G. M.

(2000). Historical and cultural roots of drinking problems among American Indians. American Journal of Public Health, 90, 344-351.

14.

Freeman

Maxwell

J. C.

Davey

(2011). Unraveling the complexity of driving while intoxicated: A study into the prevalence of psychiatric and substance abuse comorbidity. Accident Analysis & Prevention, 43, 34-39. doi:10.1016/j.aap.2010.06.004

15.

Goedde

H. W.

Agarwal

D. P.

Fritze

Meier-Tackmann

Singh

Beckmann

. . . Czeizel

(1992). Distribution of ADH2 and ALDH2 genotypes in different populations. Human Genetics, 88, 344-346.

16.

Grant

B. F.

Harford

T. C.

(1995). Comorbidity between DSM-IV alcohol use disorders and major depression: Results of a national survey. Drug and Alcohol Dependence, 39, 197-206. doi:10.1016/0376-8716(95)01160-4

17.

Gravetter

Wallnau

(2014). Essentials of statistics for the behavioral sciences (8th ed.). Belmont, CA: Wadsworth.

18.

Hartka

Johnsonte

Leino

E. V.

Motoyoshi

Temple

M. T.

Fillmore

K. M.

(1991). A meta-analysis of depressive symptomatology and alcohol consumption over time. British Journal of Addiction, 86, 1283-1298. doi:10.1111/j.1360-0443.1991.tb01704.x

19.

Hingson

R. W.

Winter

(2003). Epidemiology and consequences of drinking and driving. Retrieved from https://pubs.niaaa.nih.gov/publications/arh27-1/63-78.htm

20.

Hingson

R. W.

Zha

White

A. M.

(2017). Drinking beyond the binge threshold: Predictors, consequences, and changes in the U.S. American Journal of Preventive Medicine, 52, 717-727. doi:10.1016/J.AMEPRE.2017.02.014

21.

Hohman

Barker

Woodruff

(2017). What lies beneath: Trauma events, PTSD, and alcohol misuse in driving under the influence program clients. Journal of Social Work Practice in the Addictions, 17, 95-113. doi:10.1080/1533256X.2017.1302885

22.

Hubicka

Källmén

Hiltunen

Bergman

(2010). Personality traits and mental health of severe drunk drivers in Sweden. Social Psychiatry and Psychiatric Epidemiology, 45, 723-731. doi:10.1007/s00127-009-0111-8

23.

Hubicka

Laurell

Bergman

(2010). Psychosocial characteristics of drunk drivers assessed by the Addiction Severity Index, prediction of relapse. Scandinavian Journal of Public Health, 38, 71-77. doi:10.1177/1403494809353506

24.

Jennison

K. M.

Johnson

K. A.

(1994). Drinking-induced blackouts among young adults: Results from a national longitudinal study. International Journal of the Addictions, 29, 23-51.

25.

Jones

A. W.

Holmgren

(2009). Age and gender differences in blood-alcohol concentration in apprehended drivers in relation to the amounts of alcohol consumed. Forensic Science International, 188, 40-45. doi:10.1016/j.forsciint.2009.03.010

26.

Karagülle

Donath

Gräßel

Bleich

Hillemacher

(2010). Binge drinking in adolescents and young adults. Fortschritte der Neurologie Psychiatrie, 78, 196-202. doi:10.1055/s-0028-1110028

27.

Kuendig

Hasselberg

Laflamme

Daeppen

J.-B.

Gmel

(2008). Acute alcohol consumption and injury: Risk associations and attributable fractions for different injury mechanisms. Journal of Studies on Alcohol and Drugs, 69, 218-226. doi:10.15288/jsad.2008.69.218

28.

Lapham

S. C.

Skipper

B. J.

Hunt

W. C.

Chang

(2000). Do risk factors for re-arrest differ for female and male drunk-driving offenders? Alcoholism: Clinical and Experimental Research, 24, 1647-1655.

29.

MacCallum

R. C.

Zhang

Preacher

K. J.

Rucker

D. D.

(2002). On the practice of dichotomization of quantitative variables. Psychological Methods, 7, 19-40.

30.

Malek-Ahmadi

(2017). Age-associated alcohol and driver risk differences in older adult DUI offenders. Journal of Applied Gerontology, 36, 499-507. doi:10.1177/0733464815624152

31.

Marowitz

L. A.

(1998). Predicting DUI recidivism: Blood alcohol concentration and driver record factors. Accident Analysis & Prevention, 30, 545-554.

32.

Mars

S. G.

Bourgois

Karandinos

Montero

Ciccarone

(2014). “Every “never” I ever said came true”: Transitions from opioid pills to heroin injecting. International Journal of Drug Policy, 25, 257-266. doi:10.1016/j.drugpo.2013.10.004

33.

Martin

R. J.

Brechbiel

Chaney

B. H.

Cremeens-Matthews

Vail-Smith

(2016). Alcohol-related injuries, hazardous drinking, and BrAC levels among a sample of bar patrons. The American Journal on Addictions, 25, 132-137. doi:10.1111/ajad.12340

34.

Maxwell

J. C.

(2012). Drunk versus drugged: How different are the drivers? Drug and Alcohol Dependence, 121, 68-72. doi:10.1016/j.drugalcdep.2011.08.009

35.

Naimi

T. S.

Brewer

R. D.

Mokdad

Denny

Serdula

M. K.

Marks

J. S.

(2003). Binge drinking among US adults. Journal of the American Medical Association, 289, 70-75. doi:10.1001/jama.289.1.70

36.

National Conference of State Legislatures. (2016). Increased penalties for high blood alcohol content. Retrieved from http://www.ncsl.org/research/transportation/increased-penalties-for-high-blood-alcohol-content.aspx

37.

National Highway Traffic Safety Administration. (2017). Drunk driving. Retrieved from https://www.nhtsa.gov/risky-driving/drunk-driving

38.

National Institute of Health. (2014). As blood alcohol content (BAC) increases, so does impairment. NIH MedlinePlus, 9, 23. Retrieved from https://medlineplus.gov/magazine/issues/spring14/articles/spring14pg23.html

39.

National Institute on Alcohol Abuse and Alcoholism. (1998). Alcohol and aging. Alcohol Alert, 40. Retrieved from https://pubs.niaaa.nih.gov/publications/aa40.htm

40.

National Institute on Alcohol Abuse and Alcoholism. (2015). Alcohol overdose: The dangers of drinking too much. Retrieved from https://pubs.niaaa.nih.gov/publications/AlcoholOverdoseFactsheet/Overdosefact.htm

41.

Pechansky

Duarte

P. d. C. A. V.

De Boni

Leukefeld

C. G.

von Diemen

Bumaguin

D. B.

. . . Fuchs

D. F. P.

(2012). Predictors of positive blood alcohol concentration (BAC) in a sample of Brazilian drivers. Revista Brasileira de Psiquiatria, 34, 277-285. doi:10.1016/j.rbp.2012.06.002

42.

Peller

A. J.

Najavits

L. M.

Nelson

S. E.

LaBrie

R. A.

Shaffer

H. J.

(2010). PTSD among a treatment sample of repeat DUI offenders. Journal of Traumatic Stress, 23, 468-473. doi:10.1002/jts.20550

43.

Selzer

M. L.

(1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. The American Journal of Psychiatry, 127, 1653-1658. doi:10.1176/ajp.127.12.1653

44.

Starkey

N. J.

Charlton

S. G.

(2014). The effects of moderate alcohol concentrations on driving and cognitive performance during ascending and descending blood alcohol concentrations. Human Psychopharmacology: Clinical and Experimental, 29, 370-383. doi:10.1002/hup.2415

45.

Sudhinaraset

Wigglesworth

Takeuchi

D. T.

(2016). Social and cultural contexts of alcohol use: Influences in a social-ecological framework. Alcohol Research: Current Reviews, 38, 35-45.

46.

Sull

J. W.

S.-W.

Nam

C. M.

Ohrr

(2009). Binge drinking and mortality from all causes and cerebrovascular diseases in Korean men and women: A Kangwha cohort study. Stroke, 40, 2953-2958. doi:10.1161/STROKEAHA.109.556027

47.

Sundell

Salomaa

Vartiainen

Poikolainen

Laatikainen

(2008). Increased stroke risk is related to a binge-drinking habit. Stroke, 39, 3179-3184. doi:10.1161/STROKEAHA.108.520817

48.

Takayanagi

Spira

A. P.

Roth

K. B.

Gallo

J. J.

Eaton

W. W.

Mojtabai

(2014). Accuracy of reports of lifetime mental and physical disorders: Results from the Baltimore Epidemiological Catchment Area study. JAMA Psychiatry, 71, 273-280.

49.

Taylor

Irving

H. M.

Kanteres

Room

Borges

Cherpitel

. . . Rehm

(2010). The more you drink, the harder you fall: A systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug and Alcohol Dependence, 110, 108-116. doi:10.1016/J.DRUGALCDEP.2010.02.011

50.

Trochim

W. M.

Donnelly

J. P.

(2006). The research methods knowledge base (3rd ed.). Cincinnati, OH: Atomic Dog.

51.

U.S. Census Bureau. (2016). American community survey demographic and housing estimates, San Diego county, 2016. Retrieved from https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml?src=bkmk

52.

U.S. Department of Commerce, U.S. Census Bureau. (2001). National cancer institute sponsored tobacco use supplement to the current population survey (1998–1999). Retrieved from http://riskfactor.cancer.gov/studies/tus-cps/

53.

U.S. Department of Justice, Federal Bureau of Investigation. (2016). Crime in the United States 2015: Uniform crime reports. Retrieved from https://ucr.fbi.gov/crime-in-the-u.s/2015/crime-in-the-u.s.-2015/tables/table-29

54.

Wang

Patten

S. B.

(2001). Alcohol consumption and major depression: Findings from a follow-up study. The Canadian Journal of Psychiatry, 46, 632-638. doi:10.1177/070674370104600708

55.

Wieczorek

W. F.

Miller

B. A.

Nochajski

T. H.

(1992). The limited utility of BAC for identifying alcohol-related problems among DWI offenders. Journal of Studies on Alcohol and Drugs, 53, 415-419. doi:10.15288/jsa.1992.53.415

56.

Woodruff

S. I.

Clapp

J. D.

Sisneros

Clapp

McCabe

DiCiccio

(2009). Alcohol use risk levels among older patients screened in emergency departments in Southern California. Journal of Applied Gerontology, 28, 649-660. doi:10.1177/0733464809338040