Trauma center brief interventions for alcohol disorders decrease subsequent driving under the influence arrests

TitleTrauma center brief interventions for alcohol disorders decrease subsequent driving under the influence arrests
Publication TypeJournal Article
Year of Publication2006
AuthorsSchermer, CR, Moyers, TB, Miller, WR, Bloomfield, LA
JournalJournal of Trauma
Date PublishedJan
Publication Languageeng
ISBN Number0022-5282 (Print)0022-5282 (Linking)
Accession Number16456433
Keywords*Behavior Therapy, *Trauma Centers, Accidents, Traffic, Adult, Alcohol-Related Disorders/complications/psychology/*therapy, Automobile Driving/*psychology, Crime/*prevention & control, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Prospective Studies, Wounds and Injuries/etiology/therapy

BACKGROUND: A substantial number of trauma center admissions are related to driving under the influence (DUI); however, there has been no prior report of brief intervention (BI) after injury reducing subsequent DUI arrests. The hypothesis of this study was that injured patients receiving BI would have a lower risk of DUI arrest within 3 years of discharge than those receiving standard care (SC). METHODS: This prospective, randomized clinical trial randomly allocated patients involved in motor vehicle collisions to receive SC or a BI regarding alcohol use. The primary outcome measure was DUI arrest within 3 years of hospital discharge. DUI arrests were documented by matching demographic information to state traffic safety data. RESULTS: After randomization (N = 126), BI and SC groups were similar in age, prior DUI arrests, and alcohol screening score. BI sessions lasted an average of 30 minutes and were performed by either a social worker or a trauma surgeon. Approximately one in six participants (n = 21, 16.7%) had a DUI arrest within 3 years of hospital discharge. Within 3 years of hospital discharge, 14 of 64 patients (21.9%) in the SC group had an arrest for DUI compared with only 7 of 62 patients (11.3%) who received the BI. Multivariate analysis demonstrated that BI was the strongest protective factor against DUI arrest (odds ratio [OR], 0.32; 95% confidence interval < or =CI], 0.11-0.96). Prior number of DUIs (OR, 1.43; 95% CI, 1.03-2.01) and age (OR, 0.94; 95% CI, 0.88-0.99) were also associated with DUI arrest post-hospitalization, but alcohol screening score (OR, 1.06; 95% CI, 0.99-1.13) was not. The absolute risk reduction implies that only nine patients would need to receive a BI to prevent one DUI arrest. CONCLUSION: Patients who receive BI during a trauma center admission are less likely to be arrested for DUI within 3 years of discharge. BI represents a viable intervention to reduce DUI after trauma center admission.

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