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J Trauma Acute Care Surg. 2014 Mar;76(3):661-70; discussion 670-1. doi: 10.1097/TA.0000000000000144.

The effect on problematic drinking behavior of a brief motivational interview shortly after a first arrest for driving under the influence of alcohol: a randomized trial.

Author information

1
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.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.

LEVEL OF EVIDENCE:

Therapeutic study, level III.

PMID:
24553532
DOI:
10.1097/TA.0000000000000144
[Indexed for MEDLINE]
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