Alcohol-related Accidents Research Articles

Development of Intensive Motivational Interviewing (IMI) and Modifications for Treating Women with Alcohol Use Disorders.

Women have greater vulnerability to alcohol problems than men. They become intoxicated after drinking half as much as men, develop cirrhosis of the liver more rapidly, and have a greater risk of dying from alcohol-related accidents. Despite more serious consequences related to their drinking, treatment for women with alcohol use disorders has been understudied relative to treatment for men. Intensive motivational interviewing (IMI) is a recent psychotherapeutic intervention for substance abuse problems that draws on the principles of brief motivational interviewing (1-2 session). However, the intervention includes 9 sessions designed to enable therapists to have maximum flexibility to facilitate factors known to be important for women with substance use disorders, such as active facilitation of client-therapist collaboration, empowerment, and affirmation of strengths. This paper reviews the development of IMI, initial favorable findings for women with co-occurring methamphetamine and alcohol problems, and the design of an ongoing longitudinal study assessing the effects of MI for women with alcohol problems over a 12-month time period. Relational Theory is used as a conceptual framework for understanding IMI for women. The theory emphasizes understanding, building, and modifying interpersonal relationships as a central goal. From this perspective, self-efficacy, self-esteem, and reduction in drinking are enhanced through interpersonal connections with others. Plans for additional study of IMI are described along with suggestions for therapists.

Can positive faith-based encounters influence Australian young people’s drinking behaviours?

Purpose: Alcohol-related accidents and injuries occur disproportionately within young people – especially when gathering at social events. This study represents a partnership between a faith-based group of volunteers specifically trained to counsel and support young people to reduce their risk of alcohol-related harm, Adelaide City Council, and the South Australian Police Force aimed at reducing risk-related alcohol consumption in a metropolitan nightclub district area. It posits that supporting young people to party safely, alongside positive community engagement, may deter unsafe consumption practices – such as pre-loading and binge-drinking. Methods: Retrospective online survey evaluated the impact on attitudes of young people who received the intervention. Results: Findings suggest volunteers were perceived as positive role models who demonstrated a genuine sense of care and ability to support. As a result, one-third of respondents identified potentially more carefully pre-plan their drinking behaviour on their next night out. Conclusion: This study demonstrates that young people are responsive to positive interventions and that future pre-planning may become a more natural part of their party routine – resulting in less likelihood of alcohol-related risk. The outcome measure, that young people’s intentions to moderate their drinking as a result of positive encounters, is an important one.

You Drink, You Drive, You Die? The Dynamics of Youth Risk Taking in Response to a Change in the Legal Drinking Age

This paper exploits the reduction in the legal drinking age in New Zealand from 20 to 18 to study the dynamics of youth risk taking. Using administrative data on the universe of road accidents over a fifteen year period spanning the law change, we undertake three complimentary analyses to examine the dynamics of alcohol-related and total vehicular accidents among youth. First, using an event history approach, we find no evidence that changing the drinking age from 20 to 18 led to more vehicular accidents or alcohol-related accidents among teens. This is true both in the short-run following the law change and when examining cumulative accidents for the affected cohorts.Next, using an age-based regression discontinuity design (RDD), we find that accidents do increase after one's 18th birthday, but this appears to be a short-run phenomenon. Finally, estimating flexible parametric regression models suggests that reducing the drinking age led to a decline in risky driving by youth who were already 15 at the time of the change but had no longer-run impacts. Overall, our results support the argument that the legal drinking age can be lowered without increasing detrimental outcomes for youth and call into question previous studies that have made policy recommendations by extrapolating from results identified using age-based RDDs.

Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts.

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

Study design to evaluate cognitive behavioral therapy among a diverse sample of adults with a first-time DUI offense.

BackgroundDriving under the influence (DUI) of alcohol is a major public health concern, and many individuals continue to drink and drive even after being convicted of a DUI offense. Latinos, in particular, are disproportionately likely to be arrested for a DUI, have higher rates of recidivism, and are more likely to die in alcohol-related accidents than non-Latino Whites. Latinos also experience significant disparities in accessing alcohol-related treatment.Methods/designThis study protocol paper describes a randomized trial of cognitive behavioral therapy (CBT) compared to usual care in DUI programs for individuals with a first-time offense and at-risk drinking. We will utilize a two-group randomized design where individuals enrolled in a DUI program with a first-time conviction will be randomized to CBT (n = 150) or usual care (n = 150). Participants will be assessed at baseline, immediately post-treatment, and 6-months post-treatment. Recidivism data will be collected using administrative data within 2 years post-treatment.DiscussionThis project has the potential to benefit a large population of vulnerable individuals who are at risk of DUI recidivism. It also develops a new model of care by providing treatment in DUI programs to reduce disparities associated with poor treatment access.Trial registration NCT02588703

Locked and not loaded: First time offenders and state ignition interlock programs

Alcohol-related fatal crashes are a costly public safety concern. Using vehicular fatality data and geographical variations across the USA, I examine the effectiveness of mandatory Ignition Interlock Programs for first time offenders in preventing fatal alcohol-related accidents. I observe that the program is most effective when it is applied to a broader cross-section of first time offenders. Specifically, states that adopt ignition interlock laws that require participation of first time offenders, with blood alcohol levels of .08 or higher, see fatal accidents involving a drunk driver decrease by 9%. The results provide evidence in support of current and future policy legislation that first time offenders should participate in ignition interlock programs, which will reduce alcohol-related fatal accidents and generate large benefits to society.

Minimum wages and youth binge drinking

Binge drinking is associated with many health problems, including unintentional injuries, intentional injuries (e.g., domestic violence, sexual assault), unintended pregnancy, and liver disease. Moreover, high-volume episodic binge drinking is very prevalent among teenagers and young adults. Given that approximately 90 % of the alcohol consumed by youth under the age of 21 in the USA is in the form of binge drinking (Murphy et al. in Addict Res Theory 20(6):456–465, 2012), understanding the determinants of binge drinking behavior, particularly among youth, is important from the perspective of health and policy. In this paper, we explore the relationship between youth binge drinking and an unanticipated determinate of this behavior, minimum wage laws. Using a fixed effects regression model, we observe a positive relationship between minimum wage increases and binge drinking among teenagers. We find that, after accounting for demographic characteristics, different types of risky behaviors, excise tax, state and time fixed effects, and time-varying state effects, a $1 increase in minimum wage increases binge drinking among teenagers by approximately 9 %. Our results support recent findings that minimum wage increases are positively associated with alcohol-related accidents among teenagers (Adam et al. in Rev Econ Stat 94(3):828–840, 2012). Findings suggest that authorities should consider the unexpected impacts that minimum wage increase may have on alcohol consumption among teens and consider parallel policies to help mitigate potential negative consequences.

Legislative actions

Injuries and deaths resulting from driving under the influence of alcohol (DUI) have become a major problem in Thailand. Specifically, the World Health Organisation (WHO) reported that Thailand’s road-traffic death rate (per 100,000) was ranked third of 182 countries in 2013. To date, no research has examined whether the 2007 Road Traffic Act (RTA) has had a significant impact on DUI accidents since it was enacted. Accordingly, the purpose of this study is to evaluate the impact of the 2007 RTA on DUI accident rates in Thailand. Using monthly DUI accident figures from 2005 to 2010 obtained from the Police Information and Technology Centre, the results from an interrupted time series design are used to indicate whether the new RTA is more effective than the previous Act in preventing drug- and alcohol-related accidents in Thailand. The results supported the effectiveness of the 2007 RTA, but only in Region 10 (Bangkok), Region 1 (Nonthaburi) and Region 3 (Nakhon Ratchasima). However, it is important to highlight that even though the 2007 RTA was statistically significant in only three regions, the number of DUI accidents decreased in all 10 regions. Suggestions for future research are also provided.

Alcohol-Related Road Accidents and Holiday

Dear Editor, the recent report on ‘Alcohol-Related Road Accidents and Holiday’ is very interesting (Foster et al. , 2015). Foster et al. found ‘specific time-windows that are associated with increases in drinking and alcohol-related harm (Foster …

Temporal Patterns of Alcohol Consumption and Alcohol-Related Road Accidents in Young Swiss Men: Seasonal, Weekday and Public Holiday Effects.

To assess seasonal, weekday, and public holiday effects on alcohol-related road accidents and drinking diaries among young Swiss men. Federal road accident data (35,485 accidents) from Switzerland and drinking diary data from a large cohort of young Swiss men (11,930 subjects) were analysed for temporal effects by calendar week, weekday and public holiday (Christmas, New Years, National Day). Alcohol-related accidents were analysed using rate ratios for observed versus expected numbers of accidents and proportions of alcohol-related accidents relative to the total number. Drinking diaries were analysed for the proportion of drinkers, median number of drinks consumed, and the 90th percentile's number of drinks consumed. Several parallel peaks were identified in alcohol-related accidents and drinking diaries. These included increases on Fridays and Saturdays, with Saturday drinking extending until early Sunday morning, an increase during the summer on workdays but not weekends, an increase at the end of the year, and increases on public holidays and the evening before. Our results suggest specific time-windows that are associated with increases in drinking and alcohol-related harm. Established prevention measures should be enforced during these time-windows to reduce associated peaks.

Eat (and Drink) Better Tonight: Food Stamp Benefit Timing and Drunk Driving Fatalities

This paper examines the relationship between the timing of food stamp benefits and daily alcohol related fatal accidents. We exploit substantial exogenous variation in state food stamp distribution dates and enrollment numbers to estimate the relationship using binary outcome and count data frameworks. Our main result is that, in contrast to previous work on income receipt and mortality, alcohol related accidents with fatalities are substantially lower on the date of food stamp receipt and that the result is largely driven by a same-day effect. Further this effect is only present on weekdays. We find no effect of receipt on non-alcohol related accidents. We hypothesize that this is possibly driven by families being more likely to eat at home on distribution days.

Comparison of the Effects of Two Legal Blood Alcohol Limits: The Presence of Alcohol in Traffic Accidents According to Category of Driver in Izmir, Turkey

Objectives: Under existing Turkish road traffic law, there are 2 different blood alcohol concentration (BAC) limits allowed for drivers in 2013: zero blood alcohol and ≤0.50 g/L. All public transport, taxi, commercial, and official vehicle drivers must maintain a zero blood alcohol concentration while driving. Private vehicle drivers must maintain a BAC of 0.50 g/L or lower. The aim of the recent study was to evaluate the effect of these 2 legal blood alcohol limits on nonfatal traffic accidents that occurred due to the driver being under the influence of alcohol.Methods: This retrospective study was performed to evaluate the blood alcohol concentration of 224 drivers in nonfatal road accidents between June 2010 and July 2011 using headspace gas chromatography at the Izmir Forensic Medicine Group Presidency, Turkey. All cases evaluated by the toxicology department were entered into a database. We used descriptive statistics, χ2 test, and independent sampling test to analyze the data.Results: The total number of drivers involved in nonfatal traffic accidents was 224; 191 were private vehicle drivers and 33 were public transport, taxi, commercial, and official vehicle drivers. In the present study, alcohol was detected in the blood of about 27.2% (n = 61) of the 224 drivers. Sixty (31.4%) private vehicle drivers involved in nonfatal traffic accidents tested positive for alcohol. BAC values were also above the legal limit (0.50 g/L) in 27.7% (n = 53) of private vehicle drivers. However, the BAC was above the legal limit in only 3% (n = 1) of public transport, commercial, and official vehicle drivers involved in nonfatal traffic accidents. These results showed that private vehicle drivers subject to a BAC limit of ≤0.50 g/L were significantly associated with an increased risk of nonfatal accident involvement than drivers subject to a zero BAC limit (odds ratio [OR] = 12.29, 95% confidence interval [CI], 1.64–92.22; Fisher's exact test, P <.001). Mean BAC in private vehicle drivers subject to a 0.50 g/L level (52.60 mg/dl ± 94.84) was significantly higher than that of drivers subject to a zero alcohol level (10.76 mg/dl ± 61.80; t = 2.44, P <.001).Conclusion: In light of our results, lowering the BAC limit for private vehicle drivers may reduce the level of driving under the influence of alcohol. A change in the law will decrease the rates of alcohol-related road accidents in Turkey.

Use of alcohol mixed with energy drinks as a predictor of alcohol-related consequences two years later.

This study examines the use of alcohol mixed with energy drinks (AmED) as a predictor of alcohol problems and alcohol-related consequences and accidents two years later in a college student sample. Longitudinal data on AmED use, alcohol consequences, and alcohol problems were collected from the fall of students' second year of college to the fall of their fourth year (N = 620, 49% male). After we controlled for demographic indicators and heavy episodic drinking, AmED use was a consistent predictor of negative alcohol-related outcomes 2 years later. Compared with no AmED use, both infrequent (i.e., one to three times per month) and frequent (i.e., one or more times per week) AmED use were associated with an increased risk of negative alcohol consequences and harmful/hazardous alcohol use (≥8 on Alcohol Use Disorders Identification Test [AUDIT]). Frequent AmED use was also associated with serious alcohol problems ≥16 on AUDIT) and an increased risk of alcohol-related accidents in the subsequent 2 years. Prospective risks of alcohol consequences related to AmED use suggest a continued need for research and policy to address the surveillance, etiology, and prevention of AmED use.

Injury-Related Consequences of Alcohol Misuse Among Injured Patients Who Received Screening and Brief Intervention for Alcohol: A Latent Class Analysis

ABSTRACT. Background: Screening and brief alcohol intervention has demonstrated efficacy in improving drinking and other risk behaviors for some patient populations. However, it is not clear that brief interventions are helpful to all injured patients who drink at risk levels. This paper identifies latent classes of intervention recipients based on injury-related consequences and risks of alcohol misuse and then determines which profiles experienced the greatest improvements in drinking. Methods: A secondary analysis was conducted using data from injured patients (N = 737) who reported heavy drinking and received a brief alcohol intervention in a Level I trauma center. Latent class analysis was used to determine patient profiles, and 7 indicators commonly associated with alcohol-related injury from the Short Inventory of Problems+6 were used to determine the latent class measurement model. Covariates were regressed onto the model to assess factors related to class membership, and drinking outcomes were analyzed to examine improvements in drinking. Results: Five classes emerged from the data. The classes that reported the greatest improvements in drinking following discharge were those characterized by multiple alcohol-related risks and those characterized by a history of alcohol-related accidents and injuries. Attributing the current injury to drinking was a significant predictor of class membership among those classes that reported higher levels of improvement. Conclusions: This study provides tentative evidence that subclasses exist among heavy drinking injured patients who received a brief intervention in a Level I trauma center, and some subclasses experience greater drinking improvements than others. Further research is required to substantiate the findings of this secondary analysis.

Road Accidents, Alcohol, and Drugs: An Emergency Room Study in Florence, Italy

This article describes the potential contribution of alcohol and illicit drugs to increased risk of road accidents in Italy. Blood and urine samples were taken from patients admitted to five Emergency Rooms (ER) in metropolitan Florence, Italy, due to road traffic accidents within 3 hours of the accident. Seven hundred and thirty-five patients were tested to determine if alcohol and illicit drugs (amphetamines, opiates, cocaine, methadone, and cannabis) were present in urine and blood. Approximately 22% of patients were positive for at least one substance at night-time (20:00 to 5:59), and 18% were positive on the weekends (20:00 Friday to 05:59 Monday). Almost 80% of all alcohol-positive patients had a blood-alcohol concentration (BAC) equal to or exceeding the legal limit. Findings indicated that alcohol and illicit drugs were important contributors to traffic accident risk and suggest prevention strategies for alcohol-related road accidents in Italy may need to follow those employed in other countries, including frequent and highly visible enforcement of drunk-driving laws.

The Multitude of Alehouses: The Effects of Alcohol Outlet Density on Highway Safety

Abstract This article reports the use of detailed panel data on alcoholic beverage outlet licensing in Texas to determine the effects of alcohol outlet density on highway safety. After controlling for county heterogeneity, county and year fixed effects, and county-specific time trends, this study shows that alcohol outlet density decreases expected alcohol-related traffic accidents and arrests for driving under the influence (DUI). The negative correlation can be explained according to the reduced travel distance between alcohol outlets and home, but this distance effect does not appear when the number of off-premise alcohol outlets increases. The empirical results of this study show that the off-premise alcohol outlet density is negatively related to the number of expected accidents and DUI arrests. These results indicate that on-premise consumption decreases according to the number of available off-premise outlets. The results also indicate that this effect originates mainly from the off-premise outlets that sell alcoholic products with a relatively low alcohol content.

Thinking beyond the mean: a practical guide for using quantile regression methods for health services research.

Health services and health economics research articles commonly use multivariate regression techniques to measure the relationship of health service utilization and health outcomes (the outcomes of interest) with clinical characteristics, sociodemographic factors, and policy changes (usually treated as explanatory variables). Common regression methods measure differences in outcome variables between populations at the mean (i.e., ordinary least squares regression), or a population average effect (i.e., logistic regression models), after adjustment for other explanatory variables of interest. These are often done assuming that the regression coefficients are constant across the population – in other words, the relationships between the outcomes of interest and the explanatory variables remain the same across different values of the variables. There are times, however, when researchers, policymakers, and clinicians may be interested in group differences across the distribution of a given dependent variable rather than only at the mean. Taking a more concrete example from the literature, research on individuals' consumption of alcohol consistently reported that higher alcohol prices were associated with lower alcohol consumption.[1] This led to a call for increases in taxes as a policy lever to reduce alcohol consumption and the subsequent social costs of alcoholism and alcohol abuse. However, these studies did not provide any information about whether increased price decreased alcohol use similarly for light drinkers, moderate drinkers, and heavy drinkers. Because there are positive social benefits for light drinkers and negative health and social consequences for heavy drinkers, analyzing the demand response of different types of drinkers was important to understanding who was most likely to modify their behavior due to increasing alcohol taxes. A subsequent study[2] found light and heavy drinkers were much less price elastic than moderate drinkers; that is, higher taxes did not reduce consumption nearly as much for light and heavy drinkers as it did for moderate drinkers. The policy implication is that increasing alcohol taxes might bring in revenue (and reduce alcohol-related accidents among moderate drinkers) but will have limited success in reducing the prevalence of heavy drinking and its sequelae. Another example is that associations of interest explaining health care and health outcomes may be very different among the highest utilizers of health care, compared to individuals at the bottom or middle of the distribution of health care utilization. As a simple illustration, Figure 1 plots the relationship between the number of hours attended of a hypothetical psychotherapy intervention (x-axis) and a fictitious scale of post-intervention mental health (higher score indicates better mental health on the y-axis) for a group of 400 individuals. In this example, the regression line from an ordinary least squares (OLS) regression model is essentially flat, suggesting that there is no relationship between number of psychotherapy session-hours and mental health at follow-up. To describe the association between number of session-hours and mental health for individuals with low and high post-treatment scores on the mental health scale using OLS, the analyst extends the line up or down to the 90th and 10th quantiles in a parallel fashion, as the OLS model assumes the association between hours of psychotherapy and mental health outcome remains the same at different levels of the mental health scale. Figure 1. Prediction lines at 10th quantile, mean, and 90th quantile using ordinary least squares (OLS) regression

1579 – Migration and mental health of aborigines of siberia: new challenges of old problems

Relevance Acculturation of aborigines of Siberia and Far East of Russia was characterized by destabilizing influence of migrants and adoption of alien traditions of alcohol use. Among migrants of new wave, number of socially maladjusted migrants with depression, suicidal and addictive behavior has grown. Objective To define factors of prevention of alcohol-related over-mortality of native population based on monitoring of medicosocial indices of substance abuse situation, clinical dynamic and prognosis of alcoholism in differentiated groups. Material and methods Clinical-epidemiological and clinical-psychopathological screening of revealed (ICD-10) alcoholic patients among arctic group (Evenks, Chukchi, Koryaks, Eskimos) of north-Asian mongoloids (n=735). Group of comparison - 90 patients (F10.2) male Caucasians from this locality. Results Aborigines of Siberia show high frequency (50-65% in both sexes) of mental disorders. Men are characterized predominantly by alcohol dependence syndrome (maximum at age of 26-35 years), women - by affective disorders. Malign character of alcoholism determines high lethality of young men from suicide, alcohol-related accident, complications of comorbid somatic pathology with deformation of sex-age pyramid at 25—40 years. Severe degradation of personality (psychopath-like, cognitive defects) is typical; psychopathologic transformation of intoxication with aggression precedes development of withdrawal syndrome. Discussion Marginalization of new migration wave promotes formation of various forms of mental desadaptation, hetero (homicidal) and auto-aggressive (addictions, suicides) behavior. Factor of prevention of negative consequences of acculturation is monitoring of mental health both of aborigines and migrants. Significance is acquired by ethnological expertise of possible consequences of current migration processes for ethnodemographic parameters of scanty ethnoses.

Minimum Wages and Alcohol-Related Traffic Fatalities among Teens

Using cross-state variation in minimum wages, we observe a positive relationship between the minimum wage and the number of alcohol-related accidents involving teen drivers. A similar effect is not observed when examining accidents among adults. The results are consistent with a positive income elasticity for alcoholic beverages and driving activities among young people, in particular for consumption out of discretionary income accorded by higher minimum wages. Evidence of a sizable impact of beer taxes on alcohol-related accidents among youths suggests that beer taxes are one avenue for policymakers to consider in counteracting this unintended consequence of minimum wages.

Analysis on status of severe traffic accidents induced by driving under the influence of alcohol in motor vehicle drivers in Liuzhou city in Guangxi

Objective To study and analysis the status of severe traffic accidents induced by driving under the influence (DUI) among drivers in Liuzhou city and provide reference for relative governmental policy and preventive measures for preventing and controlling driving under influence of alcohol and drunk driving.Methods The questionnaire was designed to investigate the motor vehicle drivers (including motorcycle drivers) in 100 cases of severe traffic accident including at least one person badly injured by DUI and drivers' blood alcohol concentration (BAC) were also tested and analyzed in Liuzhou city from January 1 of 2007 to June 30 of 2007.Results It was found that the constituent ratio of severe traffic accidents attributing to DUI was 48.00％,and the total accidents was 100 including 48 ones of DUI.The incidence rate of the traffic accidents induced by DUI from 21:00 to 03:00 of the next day was 62.5％,and group of aged 30 was accounting for 46％.The longer the age of driving was,the higher incident rate of traffic accidents by DUI was.Among alcohol-related severe traffic accidents,the proportion of motorcycle drivers was higher than that in lorry and car drivers,incident rate of non-professional drivers was higher than those drivers with licences.Conclusions The DUI is one of the main reasons leading to severe traffic accidents in Liuzhou city.More abroad and effective behavior interventions against DUI among drivers must be adopted to reduce the incidence rate of DUI. Key words: Drive under the influence (DUI); Severe traffic accidents; Motor vehicle driver; Blood alcohol concentration (BAC).