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Article Excerpt
The reported prevalence of alcohol problems among samples of offenders charged with driving under the influence of alcohol (DUI) varies as much as between 4% and 87% in different investigations, depending on the definition of alcohol problems and the methods of assessment (Vingilis, 1983, 1988; Lapham et al., 2000; Brinkmann et al., 2002). Previous studies were carried out mostly on selected DUI groups--e.g., drivers with a high and illegal blood alcohol concentration (BAC), drivers involved in traffic accidents with or without a fatal outcome (Baker et al., 2002), drivers convicted of a DUI offense or undergoing treatment for alcohol problems (Andren et al., 2002). Using the Alcohol Use Disorders Identification Test (AUDIT), Conley (2001) reported that 80% among a sample of multiple-offender drunk drivers had an alcohol use disorder.
However, there is a need for studies of DUI offenders that are more representative of the whole population of drunk drivers. There is also a lack of knowledge about the prevalence of alcohol problems among drivers with a low BAC and among female DUI offenders.
Research results and experiences from other countries might not be valid for Sweden, since in most other countries legislation, alcohol use, and attitudes toward drunk driving differ considerably, mostly in a liberal direction (Valverius, 1989). Thus, Swedish DUI offenders might be more deviant from drivers generally than DUI offenders in other countries. The prevailing Swedish attitude toward mixing alcohol and driving is one of condemnation; therefore it can be expected that a greater proportion of social drinkers refrain from drinking and driving, thus creating a high proportion of heavy drinkers among drunken drivers. However, since Sweden became a member of the European Union, the Swedish alcohol policy has been successively liberalized, and during the last years increased alcohol consumption (Bergman and Kallmen, 2002, 2003) and increased alcohol involvement in fatal car accidents (Swedish National Road Administration, 2003) have been reported. The total registered alcohol consumption in Sweden increased by 13% between 1996 and 2000, and rose by 7% just during 2003 (Sweden's Statistical Databases, 2003) or by 8% according to other sources (SoRAD, 2003).
There is a general opinion that the BAC level indicates the severity of alcohol dependency. Thus a high BAC in a driver is considered a sign of an increased alcohol tolerance and alcohol problems on the basis of longtime heavy drinking. Conversely, a low BAC in a driver might imply the absence of alcohol problems. However, most often it is just a coincidence how long a time has passed between alcohol consumption and the detection of a DUI offense and how much alcohol has been metabolized by then. In a previous study (Bergman et al., 1997) of a selected group of sentenced DUI offenders in treatment, we concluded that BAC per se is a poor identification test of alcohol problems, and we hypothesized that among "low BAC drivers" there are many with alcohol problems.
The purpose of the present study was to investigate the prevalence of alcohol problems as assessed by the AUDIT in a large representative sample of male and female Swedish drivers suspected of drunk driving. The results were also compared with the corresponding prevalence of alcohol problems in a sample of control drivers and in the general population. The AUDIT results of drivers with different BAC levels, including drivers below the legal Swedish limit of 0.02%, were also compared. Finally, the validity of BAC used as a screening test of alcohol problems was evaluated in a larger, more representative sample of suspected DUI offenders than in previous studies, taking account of the sex of the driver.
Method
Samples and procedure
The study was carried out during the five-year period 1997-2001. Altogether 2,170 drivers suspected of DUI responded to the AUDIT. Since 70 of them responded more than once during the investigation period because of a relapse, only their first AUDIT and BAC results were included. Thus, the final sample investigated comprised 2,100 drivers (including 169 females; 8%) from 17 police stations representatively distributed from the north to the south of Sweden, covering both densely and sparsely populated regions, to enhance the validity of the results for the whole of Sweden.
After having been stopped by the police, the suspected DUI offender was taken to a police station for interrogation and assessment of alcohol concentration. Following the interrogation, information about the project and an AUDIT form with a stamped return envelope were given to the suspect, to be responded to at home. All the police stations affirmed that the AUDIT materials were handed out to at least 90% of the suspected drivers. Information about gender, age, BAC (both blood and breath analysis were expressed in percent grams/100 ml alcohol in blood), and the circumstances at...
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