Psychiatric and substance abuse comorbidity among a large sample of DUI Texas offenders

Research is indicating that individuals who present for DUI treatment may have competing substance abuse and mental health needs. This study aimed to examine the extent of such comorbidity issues among a sample of Texas DUI offenders. Method: Records of 36,372 DUI clients and 308,695 non-DUI clients admitted to Texas treatment programs between 2005 and 2008 were obtained from the State's administrative dataset. The data were analysed to identify the relationship between substance use, psychiatric problems, program completion and recidivism rates. Results: Analysis indicated that while non-DUI clients were more likely to present with more severe illicit substance use problems, DUI clients were more likely to have a primary problem with alcohol. Additionally, a cannabis use problem was also found to be significantly associated with DUI recidivism in the last year. In regards to mental health needs, a major finding was that depression was the most common psychiatric condition reported by DUI clients, including those with more than one DUI offence in the past year. This group were also more at risk of being diagnosed with Bipolar Disorder compared to the general population, and such a diagnosis was also associated with an increased likelihood of not completing treatment. Interestingly, female DUI and non-DUI clients were also more likely to be diagnosed with mental health problems compared to males, as well as more likely to be placed on medications at admission and have problems with methamphetamine, cocaine, and opiates. Conclusion: The findings highlight the complex competing needs of some DUI offenders who enter treatment. The results also suggest that there is a need to utilise mental health and substance abuse screening methods to ensure DUI offenders are directed towards appropriate treatment pathways as well as ensure that such interventions adequately cater for complex substance abuse and psychiatric needs.

Beyond sanctions : is there a need to treat first-time offenders?

Aims: Driving Under the Influence (DUI) enforcement can be a broad screening mechanism for alcohol and other drug problems. The current response to DUI is focused on using mechanical means to prevent inebriated persons from driving, with little attention the underlying substance abuse problems. ---------- Methods: This is a secondary analysis of an administrative dataset of over 345,000 individuals who entered Texas substance abuse treatment between 2005 and 2008. Of these, 36,372 were either on DUI probation, referred to treatment by probation, or had a DUI arrest in the past year. The DUI offenders were compared on demographic characteristics, substance use patterns, and levels of impairment with those who were not DUI offenders and first DUI offenders were compared with those with more than one past-year offense. T tests and chi square tests were used to determine significance. ---------- Results: DUI offenders were more likely to be employed, to have a problem with alcohol, to report more past-year arrests for any offense, to be older, and to have used alcohol and drugs longer than the non-DUI clients who reported higher ASI scores and were more likely to use daily. Those with one past-year DUI arrest were more likely to have problems with drugs other than alcohol and were less impaired than those with two or more arrests based on their ASI scores and daily use. Non-DUI clients reported higher levels of mood disorders than DUIs but there was no difference in their diagnosis of anxiety. Similar findings were found between those with one or multiple DUI arrests. ----------Conclusion: Although first-time DUIs were not as impaired as non-DUI clients, their levels of impairment were sufficient to cause treatment. Screening and brief intervention at arrest for all DUI offenders and treatment in combination with abstinence monitoring could decrease future recidivism.

Characteristics of Impaired Drivers Who Enter Substance Abuse Treatment

Driving under the influence (DUI) remains a serious concern. Most of the data on characteristics of DUI offenders come from driving records, with little data on the levels of impairment of DUI arrestees. This paper examines data on 103,181DUI offenders admitted to Texas treatment programs between 1988 and 2008. They reported past-year DUI arrests or came to treatment on DUI probation. The changes in the characteristics of DUI offenders over time are examined, along with the factors associated with treatment completion and abstinence 90 days after program discharge. Incorporation of substance abuse treatment with effective DUI education and intervention can improve road safety and reduce the burden of substance-related illness.

If you don’t know, you can’t help: A practical guide for alcohol and other drug screening in psychological services

Alcohol is implicated in over 60 diseases and injuries and accounted for 6.2 per cent of all male deaths globally in 2004 (WHO, 2011). Alcohol and other drug (AOD) abuse causes significant individual, family and social harms at all age levels and across all socioeconomic groups. These may result from intoxication (e.g., overdose, vulnerability to physical injury/trauma or death, consequences of impulsive behaviour, aggression and driving under the influence) and longer-term consequences (e.g., alcohol or drug-related brain injury, cardiovascular and liver diseases, blood borne viruses e.g., Chikritzhs et al., 2003, Roxburgh et al., 2013). Mental health problems may be triggered or exacerbated, and family breakdown, poor self-esteem, legal issues and lack of community engagement may also be evident. Despite the prevalence of substance use disorders and evident consequences for the individual, family and wider community, it would seem that health professionals, including psychologists, are reluctant to ask about substance use.

Arrested Drunk Drivers : Trends, social background, recidivism and mortality

The aim of this study was to examine the trends, incidence and recidivism of drunken driving during a 20-year period (1988 - 2007) using the data on all suspected drunken driving in this period. Furthermore, the association between social background and drunken driving, and the mortality of drunk drivers were studied by using administrative register data provided by Statistics Finland. The study was completely register-based. In 1989 - 1991, every year 30,000 drivers were suspected of drunken driving, but the number fell to less than 20,000 by 1994, during the economic recession. The changes in the arrest incidence of the youngest age groups were especially pronounced, most of all in the age group of 18 - 19-year olds. Even though the incidence among youth decreased dramatically, their incidence rate was still twice that of the general population aged 15 - 84 years. Drunken driving was associated with a poor social background among youth and working-aged men and women. For example, a low level of education, unemployment, divorce, and parental factors in youth were associated with a higher risk of being arrested for drunken driving. While a low income was related to more drunken driving among working-aged people, the effect among young persons was the opposite. Every third drunk driver got rearrested during a 15-year period, whereas the estimated rearrest rate was 44%. Findings of drugs only or in combination with alcohol increased the risk of rearrest. The highest rearrest rates were seen among drivers who were under the influence of amphetamines or cannabis. Also male gender, young age, high blood alcohol concentration, and arrest during weekdays and in the daytime predicted rearrest. When compared to the general population, arrested drunk drivers had significant excess mortality. The greatest relative differences were seen in alcohol-related causes of death (including alcohol diseases and alcohol poisoning), accidents, suicides and violence. Also mortality due to other than alcohol-related diseases was elevated among drunk drivers. Drunken driving was associated with multiple factors linked to traffic safety, health and social problems. Social marginalization may expose a person to harmful use of alcohol and drunken driving, and the associations are seen already among the youth. Recidivism is common among drunk drivers, and driving under the influence of illicit and/or medicinal drugs is likely to indicate worse substance abuse problems, judging from the high rearrest rates. High alcohol-related mortality in this population shows that drunken driving is clearly an indicator of alcohol abuse. More effective measures of preventing alcohol-related harms are needed, than merely preventing convicted drunk drivers from driving again.

Perfis de risco na condução de veículo em estado de embriaguez

Projecto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Criminologia

Polyconsommation d’alcool et de cannabis et comportements à risque chez les étudiants universitaires canadiens : une analyse situationnelle

La polyconsommation d’alcool et de cannabis est rapportée par un grand nombre de jeunes adultes canadiens (Flight, 2007). Les recherches épidémiologiques suggèrent que le statut de polyconsommateur est associé à certains comportements à risque, dont la consommation excessive d’alcool et la conduite d’un véhicule automobile sous l’influence de l’alcool (Jones et al. 2001; Mohler-Kuo, et al. 2003; Shillington & Clapp, 2006). Les études qui soutiennent le risque accru de comportements à risque pour les polyconsommateurs se focalisent sur l’effet des substances. En rupture avec cette approche, ce mémoire présente une étude situationnelle de la polyconsommation en examinant l’effet du statut de polyconsommateur et, pour ceux-ci l’effet de la consommation simultanée d’alcool et de cannabis, en situant l’action dans son contexte de survenu et en examinant la contribution du contexte. La probabilité d’avoir conduit une voiture sous l’influence de l’alcool et d’avoir consommé excessivement de l’alcool sera examinée auprès d’étudiants universitaires. La contribution respective des substances, des situations et de l’expérience de la vie universitaire sera examinée. La méthodologie employée repose sur la construction de modèles de régression logistique multiniveaux, à la fois chez l’ensemble des buveurs (10 747 occasions, nichées dans 4396 buveurs) et dans le sous-échantillon des polyconsommateurs (2311 occasions de consommation d’alcool, nichées dans 880 polyconsommateurs). Les données sont issues de l’Enquête sur les campus canadiens (2004), menée auprès d’un échantillon représentatif de 6282 étudiants issus de 40 universités. Le statut de polyconsommateur est associé à la consommation excessive d’alcool, mais pas à la conduite d’une voiture suite à la consommation. Cependant, la consommation simultanée d’alcool et de cannabis n’est pas associée à un risque plus élevé de consommer excessivement de l’alcool, et est négativement associée à la conduite d’une voiture après la consommation. Plusieurs caractéristiques situationnelles sont associées aux deux comportements à l’étude et diminuent la force d’association entre ces comportements et le statut de polyconsommateur.

Capacité en matière de prise de décisions chez des récidivistes de conduite avec capacités affaiblies par l’alcool

Thomas G. Brown, Ph.D., co-directeur de recherche

Les usagers de cannabis et la prise de risque sur la route

La consommation de cannabis et la conduite sous l’influence du cannabis sont des préoccupations grandissantes dans la société d’aujourd’hui. Le but de la présente étude est d’examiner plus en profondeur la relation entre la fréquence de consommation de cannabis chez les jeunes adultes et la prise de risque sur la route. Les participants (n=48) sont tous des hommes âgés de 18 à 26 ans. Ils ont complété une batterie de questionnaires ainsi qu’une tâche sur simulateur de conduite. Les résultats indiquent que la fréquence de consommation de cannabis est associée positivement avec la prise de risque auto rapportée et suggèrent une tendance positive avec les comportements risqués observés lors de la simulation de conduite en laboratoire. Lorsque les différents groupes de consommateurs sont comparés, ceux qui font un usage quotidien ou multihebdomadaire de cannabis semblent prendre plus de risques au volant que ceux qui consomment une fois semaine et moins ou encore une fois par mois et moins. De plus, il semble que plus les individus consomment fréquemment de la marijuana, plus ils ont tendance à adopter des attitudes permissives en lien avec la conduite sous l’influence de cannabis. Les implications quant à l’intervention sont discutées.

Les campagnes sociales destinées aux jeunes adultes québécois sur Internet : pistes pour l'optimisation des sites Web

Avec la montée en popularité d’Internet et des médias sociaux, de plus en plus d’organismes sociaux et publics, notamment, intègrent des plateformes Web à leurs volets traditionnels. La question d’Internet demeure toutefois peu étudiée eu égard à la publicité sociale. Ce mémoire porte donc sur la question du Web en relation avec les campagnes sociales adressées aux jeunes Québécois de 18 à 25 ans, une population particulièrement réceptive aux nouvelles technologies. Plus exactement, dans cette étude, nous avons analysé trois sites Web rattachés à des campagnes sociales (La vitesse, ça coûte cher de la SAAQ, Les ITSS se propagent du MSSS et 50 000 adeptes, 5 000 toutous de la Fondation CHU Sainte-Justine) dans l’objectif de déterminer leurs forces et leurs faiblesses pour ensuite proposer des pistes pour leur optimisation. C’est à l’aide d’une analyse critique de contenu suivie d’entrevues et d’observations individuelles auprès de 19 participants que nous sommes parvenue à suggérer des pistes pour l’optimisation des sites Web de campagnes sociales destinées aux jeunes adultes québécois. Une des plus grandes difficultés en ce qui a trait à leur conception consiste à choisir les stratégies les plus appropriées pour provoquer un changement d’attitude ou de comportement, a fortiori chez ceux qui adoptent des comportements à risque (fumer, conduire en état d’ébriété, avoir des relations sexuelles non protégées); des stratégies qui, pour être plus efficaces, devraient être adaptées en fonction des caractéristiques propres aux publics cibles et aux médias de diffusion. Afin d’analyser adéquatement les campagnes sociales, nous avons fait appel aux théories de la persuasion et aux théories sur l’influence des médias jugées pertinentes dans notre contexte puisqu’elles sont propres à ce type d’étude. Ces approches combinées nous ont permis d’intégrer à l’analyse d’une campagne donnée les contextes qui l’entourent et les pratiques dans lesquelles elle s’inscrit. Cette étude nous a, entre autres, permis de démontrer qu’il existait d’importants écarts entre les attentes et les besoins des internautes et l’offre des sites Web étudiés.

L'accertamento dei reati di guida in stato di ebbrezza e alterazione da droghe

La tesi affronta le questioni processuali connesse alla verifica dei reati di guida in stato di ebbrezza e di alterazione da droghe. La ricerca si sviluppa in tre direzioni. La prima parte studia la disciplina tedesca. L’analisi parte dalle norme sostanziali che definiscono le fattispecie incriminatrici contemplate dall’ordinamento osservato; s’interessa, poi, degli equilibri tra gli strumenti di captazione della prova utili ai reati in discorso ed il principio nemo tenetur se detegere (l’ estensione del diritto di difesa tedesco copre anche le prove reali e non prevede obblighi di collaborazione all’alcoltest). Prosegue, infine, con l’esame delle metodologie di acquisizione della prova, dall’etilometro agli screening per le droghe, sino al prelievo ematico coattivo, indispensabile per l’accertamento penale. La seconda sezione esamina gli artt. 186 e 187 del codice della strada italiano, alla luce del principio di libertà personale e del diritto a non autoincriminarsi. Particolarmente delicati gli equilibri rispetto a quest’ultimo: l’obbligatorietà di un atto potenzialmente autoaccusatorio è evitabile solo a pena di una severa sanzione. Occorre definire se il diritto di difesa copra anche il mero facere o garantisca il solo silenzio. Se si ammette, infatti, che il nemo tenetur sia applicabile anche alle prove reali, la collaborazione obbligatoria imposta al conducente è scelta incompatibile con il diritto di difesa: la disciplina italiana presenta, dunque, profili d’illegittimità costituzionale. La terza parte riguarda le problematiche processuali poste dai controlli stradali che emergono dall’analisi della giurisprudenza. Si affrontano, così, le diverse vicende della formazione della prova: ci si interroga sull’istituto processuale cui ricondurre gli accertamenti, sulle garanzie di cui goda il guidatore durante e dopo l’espletamento dell’atto, sulle eventuali sanzioni processuali derivanti da una violazione delle predette garanzie. Si esaminano, infine, le regole di apprezzamento della prova che guidano il giudice nella delicata fase valutativa.

Detection and quantification of 56 new psychoactive substances in whole blood and urine by LC-MS/MS

BACKGROUND New psychoactive substances (NPS) have become increasingly prevalent and are sold in internet shops as 'bath salts' or 'research chemicals' and comprehensive bioanalytical methods are needed for their detection. METHODOLOGY We developed and validated a method using LC and MS/MS to quantify 56 NPS in blood and urine, including amphetamine derivatives, 2C compounds, aminoindanes, cathinones, piperazines, tryptamines, dissociatives and others. Instrumentation included a Synergi Polar-RP column (Phenomenex) and a 3200 QTrap mass spectrometer (AB Sciex). Run time was 20 min. CONCLUSION A novel method is presented for the unambiguous identification and quantification of 56 NPS in blood and urine samples in clinical and forensic cases, e.g., intoxications or driving under the influence of drugs.

A Su Salud Injury Prevention expansion: Analysis of injury prevention perceptions in a Hispanic community

Unintentional injury is the leading cause of death for American ages one to 44 and is ranked in the top ten causes of death for all age groups (CDC, 2006a). A Su Salud Injury Prevention was developed to address injury prevention awareness and education. The program is a mass media education campaign that uses role models, mass media, and community outreach to prevent injury. In 2009, University Health System (UHS) expanded the program. Baseline data were collected from 426 residents in targeted neighborhoods northwest of downtown San Antonio to support the expansion. The purpose of this study was to explore injury perceptions, knowledge, and behaviors of adults living in the expansion area, and define the predominant factors associated with these perceptions. A secondary aim was to assess community awareness and willingness to participate in the program.^ Survey results showed motor vehicle crashes (MVC), falls, drinking and driving, and guns and assaults were considered the most serious injures for adults. The most serious child injuries were MVC, abuse and neglect, falls, and head injuries. Residents were knowledgeable of state seatbelt policy, and over 90% responded as compliant for seatbelt and child car seat use. Most were knowledgeable about drinking and driving state policy and negative outcomes. However, 70% of those reporting driving under the influence of alcohol within the last year engaged in repeat high risk behavior. Men and residents under the age of 55 were more likely to engage in repeat drinking and driving (OR= 3.6, 7.0 respectively). Residents consider injury prevention an important issue, and have interest in a local injury prevention program. Younger women are the most likely to participate in a local program as potential role models and volunteers.^ Results from the study are summarized into an injury prevention and demographic profile of the community that will be used to develop tailored injury prevention messages to create a more effective program, and support program coordinators in effective community engagement. Results will also be used as a comparative basis for future evaluation of a behavioral injury prevention program focused on a predominantly Mexican-American community.^

DUI program as OEF/OIF Veterans Outreach: Descriptive Data from Two Community-Based Outpatient Clinics

Although initially conceived as providing simply the preventive portion of an extended continuum of care for veterans, the Driving Under the Influence (DUI) program has turned out to be an important outreach service for active duty or recently discharged OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veterans. Veterans receive empirically-based, state-mandated education and therapy under the only Department of Veterans Affairs (VA) - sponsored DUI program in the State of Colorado, with the advantage of having providers who are sensitive to symptoms of Post-Traumatic Stress Disorder (PTSD) and other relevant diagnoses specific to this population, including Traumatic Brain Injury (TBI). In this paper, the rapid growth of this program is described, as well as summary data regarding the completion, discontinuation, and augmentation of services from the original referral concern. Key results indicated that for nearly one third (31.9%) of the OEF/OIF veterans who were enrolled in the DUI program, this was their initial contact with the VA health care system. Furthermore, following their enrollment in the DUI program, more than one fourth (27.6%) were later referred to and attended other VA programs including PTSD rehabilitation and group therapy, anger management, and intensive inpatient or outpatient dual diagnosis programs. These and other findings from this study suggest that the DUI program may be an effective additional pathway for providing treatment that is particularly salient to the distinctive OEF/OIF population; one that may also result in earlier intervention for problem drinking and other problems related to combat. Relevant conclusions discussed herein primarily aim to improve providers' understanding of effective outreach, and to enhance the appropriate linkages between OEF/OIF veterans and existing VA services.

Examination of DWI conviction rate procedures.

National Highway Traffic Safety Administration, Washington, D.C.