Abstract
BackgroundDespite a decrease in driving under the influence of alcohol (DUIA) prevalence over the past decades, DUIA prevalence still remains high in the United States. To date, there is limited research examining whether different types of substance users have different trends in DUIA. This study sought to assess trends and variables associated with DUIA by substance use type.MethodsNational Survey on Drug Use and Health (NSDUH) is a cross-sectional, nationally representative population-based survey. By using the NSDUH 2008–2014, we performed the Joinpoint analysis to identify time trends of DUIA in each group of substance users (aged ≥18 years). Logistic regression analysis was used to explore association between substance use type and DUIA and to identify variables associated with DUIA.ResultsAdults who reported alcohol or drug use in the past year were classified into different groups based on past-year substance use status: alcohol use only (n = 141,521) and drug use regardless alcohol use. Drug users included prescription opioids only (n = 5337), marijuana only (n = 32,206), other single drug (n = 3789), prescription opioids-marijuana (n = 3921), multiple prescription drugs (n = 1267), and other multiple drugs (n = 18,432). The Joinpoint analysis showed that DUIA prevalence decreased significantly from 2008 to 2014 among alcohol only users (Average Annual Percent Change [AAPC] = − 2.8), prescription opioids only users (AAPC = -5.4), marijuana only users (AAPC = -5.0), prescription opioids-marijuana users (AAPC = -6.5), multiple prescription drug users (AAPC = -7.4), and other multiple drug users (AAPC = -3.2). Although the estimate was not statistically significant, other single drug users showed a decreasing trend (AAPC = -0.9). Substance use type was significantly associated with DUIA in the adjusted logistic regression. All drug use groups, relative to the alcohol only group, had elevated odds of DUIA, and the odds were especially elevated for the multiple drug use groups (prescription opioids-marijuana, adjusted odds ratio [AOR] = 2.71; multiple prescription drugs, AOR = 2.83; and other multiple drugs, AOR = 3.68). Additionally, younger age, male sex, being white, higher income, and alcohol abuse/dependence were positively associated with DUIA.ConclusionsDUIA prevalence decreased over time and the magnitude of this reduction differed by substance use type. DUIA interventions need to be tailored to substance use type and individual characteristics.
Highlights
Despite a decrease in driving under the influence of alcohol (DUIA) prevalence over the past decades, DUIA prevalence still remains high in the United States
Prevalence trends of past-year DUIA in the United States, 2008–2014 (Table 2) Overall, other multiple drug users had the highest prevalence of past-year DUIA (48.30, 95% Confidence interval (CI): 47.01–49.60), followed by prescription opioids-marijuana users (39.37, 95% CI: 37.12–41.63), multiple prescription drug users (34.70, 95% CI: 30.79–38.61), marijuana only users (29.10, 95% CI: 28.13–30.07), other single drug users (27.50, 95% CI: 25.43–29.57), and prescription opioids only users (22.16, 95% CI: 20.20–24.13)
The estimates were not statistically significant, DUIA prevalence among other single drug users increased by 8.7% per year (APC = 8.7, 95% CI: -13.2, 36.2) from 2008 to 2012 and decreased by 17.6% per year (APC = -17.6, 95% CI: -57.2, 58.8) from 2012 to 2014
Summary
Despite a decrease in driving under the influence of alcohol (DUIA) prevalence over the past decades, DUIA prevalence still remains high in the United States. This study sought to assess trends and variables associated with DUIA by substance use type. During the past few decades in the United States, the prevalence of driving under the influence of alcohol (DUIA) has decreased [1, 2]. Results from the National Survey on Drug Use and Health (NSDUH) showed that from 2005 to 2014, there was a 37% proportional decline in DUIA prevalence among US adults aged 18–24 years [3]. According to results from the 2016 NSDUH, 8.2% of Americans aged 16 or older reported DUIA during the past year [5]. Economic costs associated with alcohol-involved crashes were estimated to be $52 billion [11]
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