Mullen Jillian, Ryan Stacy R, Mathias Charles W, Dougherty Donald M
a Department of Psychiatry , The University of Texas Health Science Center at San Antonio , San Antonio , Texas.
Traffic Inj Prev. 2015;16(7):637-44. doi: 10.1080/15389588.2015.1013189.
This study aimed to characterize and compare the treatment needs of adults with driving while intoxicated (DWI) offenders recruited from a correctional residential treatment facility and the community to provide recommendations for treatment development.
A total of 119 adults (59 residential, 60 community) with at least one DWI offense were administered clinical diagnostic interviews to assess substance use disorders and completed a battery of questionnaires assessing demographic characteristics, legal history, psychiatric diagnoses, medical diagnoses, and health care utilization.
Almost all (96.6%) DWI offenders met clinical diagnostic criteria for an alcohol use disorder, approximately half of the sample also met diagnostic criteria for comorbid substance use disorders, and a substantial proportion also reported psychiatric and medical comorbidities. However, a high percentage were not receiving treatment for these issues, most likely as a result of having limited access to care, because the majority of participants had no current health insurance (64.45%) or primary care physician (74.0%). The residential sample had more extensive criminal histories compared to the community sample but was generally representative of the community in terms of their clinical characteristics. For instance, the groups did not differ in rates of substance use, psychiatric and medical health diagnoses, or the treatment of such issues, with the exception of alcohol abuse treatment.
DWI offenders represent a clinical population with high levels of complex and competing treatment needs that are not currently being met. Our findings demonstrate the need for standardized screening of DWI offenders and call for the development of a multimodal treatment approach in efforts to reduce recidivism.
本研究旨在描述和比较从惩教性住院治疗机构和社区招募的醉酒驾驶（DWI）成年罪犯的治疗需求，以为治疗方案的制定提供建议。
对总共119名有至少一次DWI犯罪记录的成年人（59名来自住院治疗机构，60名来自社区）进行临床诊断访谈，以评估物质使用障碍，并完成一系列问卷，评估人口统计学特征、法律史、精神科诊断、医学诊断和医疗保健利用情况。
几乎所有（96.6%）的DWI罪犯都符合酒精使用障碍的临床诊断标准，大约一半的样本还符合共病物质使用障碍的诊断标准，并且相当一部分人还报告有精神科和医学共病。然而，很大比例的人没有针对这些问题接受治疗，很可能是因为获得治疗的机会有限，因为大多数参与者目前没有医疗保险（64.45%）或初级保健医生（74.0%）。与社区样本相比，住院治疗机构样本的犯罪历史更广泛，但在临床特征方面总体上代表了社区情况。例如，除了酒精滥用治疗外，两组在物质使用、精神科和医学健康诊断或此类问题的治疗率方面没有差异。
DWI罪犯是一个临床群体，有着高水平的复杂且相互竞争的治疗需求，目前这些需求未得到满足。我们的研究结果表明需要对DWI罪犯进行标准化筛查，并呼吁制定多模式治疗方法以努力减少累犯。
