Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Veterans Administration, Connecticut Healthcare System, West Haven, Connecticut.
J Stud Alcohol Drugs. 2019 Jan;80(1):114-119. doi: 10.15288/jsad.2019.80.114.
Alcohol-impaired driving is a significant source of injury and morbidity in the United States. People with alcohol use disorder (AUD) are more likely to drive while impaired by alcohol than their nonclinical counterparts. Less is known about rates of impaired driving in people with AUD and a comorbid substance use disorder (SUD). The current study examined the association among AUD, other SUDs, and alcohol-impaired driving in a nationally representative sample of adults in the United States.
Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; n = 36,309). AUD and SUD diagnoses according to DSM-5 criteria were determined using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. We compared rates of past-year alcohol-impaired driving in people with AUD, another SUD (i.e., cannabis use disorder, stimulant use disorder, opioid use disorder), or AUD comorbid with another SUD against those with no past-year AUD or SUD diagnoses.
People with AUD had increased odds (adjusted odds ratios [AORs] = 15.85-28.27) of past-year alcohol-impaired driving behavior compared with past-year drinkers with no AUD or SUD. Although other SUDs per se were not consistently associated with increased odds of these behaviors (AORs = 0.28-4.07), people with AUD comorbid with SUD showed comparatively higher odds of these behaviors (AORs = 30.46-93.97). These effects held even when alcohol use quantity/frequency and AUD severity were controlled for.
People with AUD and a comorbid SUD are at high risk for alcohol-impaired driving. More research is needed to understand the factors mediating increased odds of driving while impaired in people with substance use comorbidities, especially considering societal movement toward cannabis legalization.
在美国，酒后驾车是造成伤害和发病的一个重要原因。患有酒精使用障碍（AUD）的人比非临床患者更有可能在酒后驾车。然而，对于 AUD 合并其他物质使用障碍（SUD）患者的酒后驾车发生率知之甚少。本研究在美国全国代表性的成年人样本中，调查了 AUD、其他 SUD 与酒后驾车之间的关联。
数据来自国家酒精相关状况流行病学调查（NESARC-III；n=36309）。使用酒精使用障碍和相关障碍访谈表-5 按照 DSM-5 标准确定 AUD 和 SUD 诊断。我们比较了 AUD、另一种 SUD（即大麻使用障碍、兴奋剂使用障碍、阿片类药物使用障碍）或 AUD 合并另一种 SUD 的患者与过去一年 AUD 或 SUD 诊断无患者的过去一年酒后驾车发生率。
与过去一年 AUD 或 SUD 诊断无患者相比，AUD 患者过去一年酒后驾车行为的可能性更高（校正比值比 [AOR] = 15.85-28.27）。尽管其他 SUD 本身并不总是与这些行为的可能性增加相关（AOR=0.28-4.07），但 AUD 合并 SUD 的患者这些行为的可能性更高（AOR=30.46-93.97）。即使控制了饮酒量/频率和 AUD 严重程度，这些影响仍然存在。
患有 AUD 和合并 SUD 的患者酒后驾车的风险很高。需要更多的研究来了解介导合并物质使用障碍患者酒后驾车可能性增加的因素，特别是考虑到社会向大麻合法化的方向发展。
