Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First‐Time DUI Offense

Abstract

BackgroundDriving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence‐based therapy in these programs may help prevent DUI recidivism.MethodsWe conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first‐time DUI offense who screened positive for at‐risk drinking in the past year. Participants were randomly assigned to a 12‐session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent‐to‐treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol‐related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.ResultsParticipants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4‐ and 10‐month follow‐ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10‐month follow‐up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4‐ and 10‐month follow‐ups. Participants in both UC and CBT reported significant within‐group reductions in 2 of 5 outcomes, binge drinking and alcohol‐related consequences, at 10‐month follow‐up (p < 0.001).ConclusionsIn the short‐term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short‐term reductions in impaired driving.

Inclusion and reporting of sex, gender, and race/ethnicity in randomized controlled trials of nonpharmacological treatments for alcohol use disorder: A meta‐epidemiologic review

“…The proportion of articles consistently using sex terms (χ 2 = 0.09, p = 0.77), consistently using gender terms (χ 2 = 0.10, p = 0.75), and interchangeably using sex and gender terms (χ 2 = 0.57, p = 0.45) did not significantly change from the time period spanning 1997 to 2010 to the time period spanning 2011 to 2021 based on a chi‐square test of difference in proportions (see Figure 2). Of the 123 articles that did not include a sex/gender‐specific sample, only two (1.3%) reported on subgroup analyses to examine whether treatments were differentially effective based on participant sex/gender (in addition to Osilla et al, 2019, which included subgroup analyses based on sex/gender and race/ethnicity, Drislane et al, 2020). Only 18.1% ( n = 28) of articles described concerns regarding sex/gender inclusion or about the generalizability of study findings as a result of their sample's sex/gender composition in their limitations.…”

“…Excluding these articles from those considered to have fully reported on their sample's racial/ethnic composition, the number of articles reporting full racial/ethnic information drops from 96 articles (61.9%) to 25 (16.1%). Additionally, no articles (except for Osilla et al, 2019, which included subgroup analyses based on sex/gender and race/ethnicity, Drislane et al, 2020) reported conducting subgroup analyses to examine differences in treatment efficacy across racial/ethnic groups alone, and only 18.1% ( n = 28) of articles mentioned racial/ethnic inclusion (or lack thereof) as a limitation to their study.…”

“…Of the total 155 articles, 57 articles (36.8%) fully reported on both their sample's sex/gender and racial/ethnic breakdown. Only two articles reported on subgroup analyses examining differential treatment efficacy by both sex/gender and race/ethnicity (Drislane et al, 2020;Osilla et al, 2019), and only 10 articles (6.5%) mentioned inclusion and diversity with respect to both sex/gender and race/ ethnicity in their discussion. Another eight articles (5.2%) mentioned a lack of "diversity" broadly in their limitations but did not specifically mention sex/gender or race/ethnicity.…”

Study design to evaluate a group-based therapy for support persons of adults on buprenorphine/naloxone

“…We will use methods from our previous studies to assess adherence to session content [ 54 , 55 ]. A basic checklist will be developed outlining each session’s content.…”