Two problems challenge the accurate identification of alcoholics in a Driving Under Influence (DUI) population. The first problem is a low validity of self-report of alcohol problems in DUI subjects. Second, in many instances a diagnosis of alcoholism has to be substantiated in legal procedures. A diagnosis based on expert opinion and data with an unreliable correlation with alcoholism will meet problems in court. Recent diagnostic procedures are restrictive because they must rely on objective and reliable data such as physical signs of alcoholism or state markers of excessive alcohol use. One can assume that such diagnostic procedures will result in under-diagnosis because physical signs of alcoholism are late symptoms of alcoholic disease and because approximately 5-20% of alcohol dependent patients and approximately 40-60% of patients with alcohol abuse show no elevations in biological markers. Research suggests a considerable prevalence of Alcohol Use Disorders (AUD) in DUI populations. However, there is reason for scepticism about the validity of most of the prevalence values based on biochemical markers. This suggests that the reported prevalence values are conservative.
Samenvatting