Mental Disorders Associated with Driving under the Influence of Alcohol and/or Drugs: A Register-Based Study

Abstract

Background/Aims: Mental disorders are associated with driving under the influence (DUI), but the evidence is scarce and mostly focused on a limited group of repeat drunken drivers. Thus, the aim of this study was to examine which mental disorders were risk factors for DUI of alcohol only (DUIA), of illicit drugs (DUID) or of alcohol and psychoactive prescription drugs (DUIAP), and whether and how the risk differs over time. Methods: A register-based case-control study was conducted. Cases (n = 44,188) suspected by the police of DUI during 1997–2007 and controls (n = 45,148) were drawn from the general Finnish population. The official national register of hospital treatments was the data source for mental disorders. The effects of mental disorders on DUI were estimated using logistic regression analysis. Results: Substance use disorders increased the risk of DUI overall. Childhood- and adolescence-onset disorders were a strong predictor of DUID, and bipolar and depressive disorders predicted DUIAP. The risk was highest soon after hospital admission with a psychiatric diagnosis, but it decreased over time. Conclusions: Actions to prevent DUI should be developed and implemented during the treatment of mental disorders.

Violent Behavior and Driving under the Influence of Alcohol: Prevalence and Association with Impulsivity among Individuals in Treatment for Alcohol Dependence in Poland

“…Not all individuals with alcohol use disorders engage in DUI or interpersonal violence, and it is important to understand the factors that may increase the likelihood of these risky behaviors in order to inform efforts to intervene with alcohol-dependent individuals to reduce injury-related outcomes. Our results indicate that male gender, early onset of drinking, and duration of alcohol problems were shared risk factors for violence (FUI) and being arrested for DUI, similar to the results of Karjalainen et al [2]. It might be expected that older age would be associated with both DUI and FUI, given that older participants would have had more years over which to experience these problems, but this was not the case among this sample/cohort.…”

“…The theory proposed by Badawy [46], who suggested that serotonin deficiency may be a common pathway leading to alcohol dependence as well as aggression, could also partially explain the correlation of high impulsivity levels with violence but not driving while intoxicated. Research also indicates that an earlier age of onset of problem drinking is correlated with higher impulsivity, which may be a consequence of a ‘novelty-seeking' trait [47,48,49,50], leading to risky behaviors [2]. Prior studies have shown that impulsivity is associated with earlier experimentation with drugs and alcohol [51] and promotes alcohol abuse at younger ages [52,53,54].…”

“…Driving under the influence (DUI) 1 and engaging in interpersonal violence are two injury-related problems of high public health importance that have both been linked to alcohol consumption [1,2]. Driving while intoxicated increases the risk of accidents, and motor vehicle injuries are a leading cause of premature death globally [3].…”

“…Increasing alcohol consumption [8 ]and poor quality of roads further exacerbates the problem of DUI in Poland. Evidence from non-Polish samples has demonstrated the relationship between alcohol use and traffic accident injury [2]. In a recent study in Norway, the odds ratio (OR) for nonfatal accidents among drivers who had consumed alcohol was as high as 36.1 compared to sober drivers [9].…”

Non-prescribed use of psychoactive prescription drugs among drug-impaired drivers in Sweden

“…Because psychoactive drugs may impair driving ability, their users are at increased risk of traffic accidents (Dassanayake et al, 2011;Gustavsen et al, 2008;Hetland and Carr, 2014). Moreover, mental health problems as well as substance use disorders are more common (Freeman et al, 2011;Karjalainen et al, 2012;Lapham et al, 2001) and psychoactive drugs are more commonly prescribed among drug-impaired drivers than in the general population.…”