From the Department of Surgery (G.H.U., J.B.Y., C.R.S.), University of California, Davis, Medical Center; and Sacramento Police Department (L.A.T., D.M.C., C.J.M.), Sacramento; and Department of Surgery (L.J.O.), Mercy San Juan Hospital, Carmichael, California; and Department of Health Management & Policy (D.E.), University of Michigan, Ann Arbor, Michigan.
J Trauma Acute Care Surg. 2014 Mar;76(3):661-70; discussion 670-1. doi: 10.1097/TA.0000000000000144.
In medical settings, motivational interviewing-based "brief intervention" (BI) counseling reduces alcohol-related risk-taking behavior and harm in high-risk populations. Individuals arrested for driving under the influence of alcohol (DUI) are another at-risk population. We sought to determine whether a BI administered shortly after a first DUI arrest might decrease problematic drinking behavior.
We conducted a single-center, parallel-group, double-blinded superiority randomized trial (NCT01270217), enrolling first-time DUI arrestees at a county jail from December 2010 through April 2011. Before their release, we randomized participants by computer-generated sequence to either a single BI or no discussion. We assessed 90-day change in Alcohol Use Disorders Identification Test (AUDIT) scores (range 0-40, higher values indicating more problematic drinking) as the primary outcome.
We enrolled 200 subjects (100 to each arm), and 181 (90.5%, 86 control and 95 BI) completed the 90-day follow-up. Mean (SD) age was 30 (10) years, and 50% were men. Mean (SD) blood alcohol concentration upon arrest was 0.14% (0.04%). Mean (SD) baseline AUDIT scores were 8.8 (5.8) among control subjects and 7.7 (6.3) among BI subjects. At 90 days, AUDIT scores decreased by a mean (SD) 4.7 (5.1) units among control subjects and 3.4 (5.0) among BI subjects (difference, -1.3; 95% confidence interval [CI], -2.8 to +0.1). The likelihood of subsequent binge drinking [relative risk (RR) 1.6; 95% CI, 0.8-3.0; BI vs. control], abstinence (RR, 0.9; 95% CI, 0.4-2.1), alcohol-related injury to self or others (RR, 0.4; 95% CI, 0.1-2.4), and seeking treatment (RR, 1.2; 95% CI, 0.8-1.7) did not differ.
A single BI counseling session shortly after first-time DUI arrest does not reduce 90-day self-reported drinking behavior or increase seeking treatment for drinking beyond that which occurs without such a discussion.
Therapeutic study, level III.
在医疗环境中，基于动机访谈的“简短干预”（BI）咨询可减少高危人群的与酒精相关的冒险行为和伤害。因酒后驾车（DUI）被捕的个体也是另一个高危人群。我们试图确定在首次 DUI 被捕后进行 BI 是否可能减少不良饮酒行为。
我们进行了一项单中心、平行组、双盲优效随机试验（NCT01270217），于 2010 年 12 月至 2011 年 4 月在县监狱招募首次 DUI 被捕者。在他们获释之前，我们通过计算机生成的序列将参与者随机分配至 BI 组或无讨论组。我们评估了 90 天内酒精使用障碍识别测试（AUDIT）评分的变化（范围 0-40，分数越高表示饮酒问题越严重）作为主要结局。
我们共招募了 200 名受试者（每组 100 名），其中 181 名（86 名对照组和 95 名 BI 组）完成了 90 天的随访。平均（SD）年龄为 30（10）岁，50%为男性。被捕时平均（SD）血液酒精浓度为 0.14%（0.04%）。对照组的平均（SD）基线 AUDIT 评分为 8.8（5.8）分，BI 组为 7.7（6.3）分。在 90 天时，对照组的 AUDIT 评分平均（SD）下降了 4.7（5.1）分，BI 组下降了 3.4（5.0）分（差异，-1.3；95%置信区间[CI]，-2.8 至 0.1）。随后 binge 饮酒的可能性[相对风险（RR）1.6；95% CI，0.8-3.0；BI 与对照组]、戒酒（RR，0.9；95% CI，0.4-2.1）、与酒精相关的自我或他人受伤（RR，0.4；95% CI，0.1-2.4）和寻求治疗（RR，1.2；95% CI，0.8-1.7）无差异。
在首次 DUI 被捕后不久进行单次 BI 咨询并不能减少 90 天内自我报告的饮酒行为，也不会增加寻求饮酒治疗的可能性，而不进行这种讨论也会出现这种情况。
治疗研究，III 级。
