Within the criminal justice system, provisions exist for dealing with persons convicted of driving while impaired by alcohol. However, only a small fraction of the impaired drivers who are at a high risk for involvement in crashes are arrested. Beitel, Sharp, and Glauzm (2000) estimated the probability of being arrested while driving under the influence of alcohol (with a blood alcohol concentration [BAC] at or above .10 g/dL) to be about 1 in 200. In addition, Dill, Wells-Parker, and Soderstrom (2004) estimated that only about 23% of alcohol-impaired drivers who are treated either in emergency rooms or trauma centers are convicted of that offense and therefore most do not receive intervention for their alcohol problems through court referral or legal sanction. Thus, the reduction of traffic crashes is likely to depend on identifying and helping drivers who regularly or occasionally drink to intoxication before they are arrested for violations. Many of these high-risk drivers are unaware of their alcohol-related risk and fail to seek assistance. Until recently, typical medical health assessments and medical care failed to address this issue and a trisk drinkers continued to go undetected. Now, however, the development of screening and brief intervention (SBI) programs provide opportunities for identifying at-risk drinking drivers outside of the criminal justice system before they injure themselves or others. Over a quarter-century of research has found that many people who engage in risky drinking can modify their behavior with brief cautioning, assistance, and encouragement within healthcare and other community settings. The purpose of this paper is to give the highway safety community an overview of SBI. SBI may be a powerful community tool to decrease the likelihood of drinking and driving by those who drink alcohol in a hazardous manner or are at risk for the more serious medical diagnoses of alcohol abuse or dependence. This paper addresses the rationale for targeting those less severely impaired by substance misuse (including their risk of involvement in alcohol-impaired driving crashes), defines SBI, describes examples of some existing programs, outlines their results and, last, discusses the current status and challenges of the implementation of SBI. While this paper focuses on driving and alcohol use, it is important to note that while the research is less developed, SBI may have the same positive effect for people using other psychoactive substances, such as marijuana. (Author/publisher)
Samenvatting