使用经皮酒精监测的应急管理措施减少醉酒驾驶（DWI）被捕者大量饮酒的有效性：一项随机对照试验。
Effectiveness of contingency management using transdermal alcohol monitoring to reduce heavy drinking among driving while intoxicated (DWI) arrestees: A randomized controlled trial.
作者信息
Dougherty Donald M, Moon Tae-Joon, Liang Yuanyuan, Roache John D, Lamb Richard J, Mathias Charles W, Wasserman Alexander M, Wood Erin E, Hill-Kapturczak Nathalie
机构信息
Department of Psychology, University of North Texas, Denton, Texas, USA.
Department of Health, Behavior, and Society, University of Texas School of Public Health San Antonio, San Antonio, Texas, USA.
出版信息
Alcohol Clin Exp Res (Hoboken). 2023 Oct;47(10):1989-2001. doi: 10.1111/acer.15180. Epub 2023 Sep 13.
BACKGROUND
Driving while intoxicated (DWI) is a serious public health problem. However, treatment for DWI arrestees is not readily available. This study examines the effectiveness of a contingency management (CM) procedure using transdermal alcohol concentration (TAC) monitoring to reduce drinking among DWI arrestees.
METHOD
The study participants were 216 DWI arrestees under pretrial and included both Mandated participants undergoing court-ordered TAC monitoring and Non-Mandated participants wearing a study-provided TAC monitor. Participants were randomly assigned to either a CM (Mandated = 35; Non-Mandated = 74) or a Control condition (Mandated = 37; Non-Mandated = 70) and completed the 8-week intervention. CM participants received $50/week for not exceeding a TAC of 0.02 g/dL during the previous week. Payments to Controls were yoked to the CM group.
RESULTS
Among Non-Mandated participants, the probability of meeting the contingency was higher and remained stable (about 65%) over time in the CM group, whereas the probability was lower and declined in the Control group, widening the gaps in the probability between the study conditions (16.7%-24.1% greater in the CM group from visit 4 to 8, all p < 0.05). Among Mandated participants, the probability was not significantly different between conditions (p = 0.06-0.95). Furthermore, among Non-Mandated participants, the percentage of heavy drinking days remained low (9.16%-11.37%) in the CM group, whereas it was greater and increased over time (17.43%-26.59%) in the Control group. In Mandated participants, no significant differences in percent heavy drinking days were observed between conditions (p = 0.07-0.10).
CONCLUSION
We found that contingency effects on alcohol use are more pronounced among frequent and heavy alcohol users, i.e., Non-Mandated DWI arrestees. However, for individuals whose drinking was already suppressed by existing contingencies (i.e., court-mandated TAC monitoring), our CM procedure did not produce additional reductions in drinking.
背景
酒后驾车（DWI）是一个严重的公共卫生问题。然而，针对酒后驾车被捕者的治疗方法并不容易获得。本研究探讨了一种使用经皮酒精浓度（TAC）监测的应急管理（CM）程序在减少酒后驾车被捕者饮酒方面的有效性。
方法
研究参与者为216名审前酒后驾车被捕者，包括接受法庭命令进行TAC监测的强制参与者和佩戴研究提供的TAC监测器的非强制参与者。参与者被随机分配到CM组（强制参与者 = 35人；非强制参与者 = 74人）或对照组（强制参与者 = 37人；非强制参与者 = 70人），并完成为期8周的干预。CM组参与者如果前一周的TAC不超过0.02 g/dL，每周可获得50美元。对照组的支付与CM组挂钩。
结果
在非强制参与者中，CM组满足应急条件的概率更高，且随时间保持稳定（约65%），而对照组的概率较低且呈下降趋势，扩大了研究条件之间概率的差距（从第4次访视到第8次访视，CM组比对照组高16.7%-24.1%，所有p < 0.05）。在强制参与者中，不同条件下的概率没有显著差异（p = 0.06-0.95）。此外，在非强制参与者中，CM组重度饮酒日的百分比仍然较低（9.16%-11.37%），而对照组则较高且随时间增加（17.43%-26.59%）。在强制参与者中，不同条件下重度饮酒日的百分比没有显著差异（p = 0.07-0.10）。
结论
我们发现，应急管理对酒精使用的影响在频繁和大量饮酒者，即非强制酒后驾车被捕者中更为明显。然而，对于饮酒已被现有应急措施（即法庭命令的TAC监测）抑制的个体，我们的CM程序并未进一步减少饮酒量。
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