Demographics & Post-Mortem Toxicology Findings in Deaths among People Arrested Multiple Times for Use of Illicit Drugs and/or Impaired Driving

BACKGROUND:

Multiple arrests for use of illicit drugs and/or impaired driving strongly suggests the existence of a personality disorder and/or a substance abuse problem.

METHODS:

This retrospective study (1993-2010) used a national forensic toxicology database (TOXBASE), and we identified 3943 individuals with two or more arrests for use of illicit drugs and/or impaired driving. These individuals had subsequently died from a fatal drug poisoning or some other cause of death, such as trauma.

RESULTS:

Of the 3943 repeat offenders 1807 (46%) died from a fatal drug overdose and 2136 (54%) died from other causes (p<0.001). The repeat offenders were predominantly male (90% vs 10%) and mean age of drug poisoning deaths was 5 y younger (mean 35 y) than other causes of death (mean 40 y). Significantly more repeat offenders (46%) died from drug overdose compared with all other forensic autopsies (14%) (p<0.001). Four or more drugs were identified in femoral blood in 44% of deaths from poisoning (drug overdose) compared with 18% of deaths by other causes (p<0.001). The manner of death was considered accidental in 54% of deaths among repeat offenders compared with 28% for other suspicious deaths (p<0.001). The psychoactive substances most commonly identified in autopsy blood from repeat offenders were ethanol, morphine (from heroin), diazepam, amphetamines, cannabis, and various opioids.

CONCLUSIONS:

This study shows that people arrested multiple times for use of illicit drugs and/or impaired driving are more likely to die by accidentally overdosing with drugs. Lives might be saved if repeat offenders were sentenced to treatment and rehabilitation for their drug abuse problem instead of conventional penalties for drug-related crimes

Purchase full article at:   http://goo.gl/znHMKi

By:  Ahlner J1, Holmgren A2, Jones AW3.

• 1Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden; Department of Clinical Pharmacology, Faculty of Medicine, Linköping University, Linköping, Sweden.
• 2Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden.
• 3Department of Forensic Genetics and Forensic Toxicology, Swedish National Board of Forensic Medicine, Linköping, Sweden; Department of Clinical Pharmacology, Faculty of Medicine, Linköping University, Linköping, Sweden. Electronic address: wayne.jones@liu.se. 
• Forensic Sci Int. 2016 Feb 3;265:138-143. doi: 10.1016/j.forsciint.2016.01.036.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Correlates of Marijuana Drugged Driving and Openness to Driving While High: Evidence from Colorado and Washington

Aims

A potential unintended consequence of legalizing recreational marijuana is increased marijuana-related driving impairment. Some states where recreational marijuana is legal have begun implementing interventions to mitigate driving under the influence (DUI) of marijuana, including media campaigns to increase knowledge about DUI laws. However, little is known about the associations between knowledge of DUI laws and marijuana DUI behavior. In this study, we provide new data from a survey of marijuana users in Colorado and Washington to examine associations between marijuana drugged driving and two potential behavioral precursors of marijuana DUI. We also explore other factors that may influence marijuana DUI.

Methods

Data are from an online survey of marijuana users in Colorado and Washington. Respondents who reported any marijuana use in the past 30 days (n = 865) served as the analytic sample. We examined prevalence of two behavioral outcomes: (1) any driving of a motor vehicle while high in the past year and (2) driving a motor vehicle within 1 hour of using marijuana 5 or more times in the past month. Additional outcomes measuring willingness to drive while high were also assessed. Logistic regressions were used to estimate each outcome as a function of two multi-item scales measuring knowledge of the legal consequences of driving high and perceptions that driving while high is not safe. Additional covariates for potential confounders were included in each model.

Results

Prevalence of past-year driving while under the influence of marijuana was 43.6% among respondents. The prevalence of driving within 1 hour of using marijuana at least 5 times in the past month was 23.9%. Increased perception that driving high is unsafe was associated with lower odds of past-year marijuana DUI (OR = 0.31, P < 0.01) and lower past-month odds of driving 5 or more times within 1 hour of using marijuana (OR = 0.26, P < 0.01). Increased knowledge of marijuana DUI laws was also associated with lower odds of each of these outcomes (OR = 0.63, P < 0.01, OR = 0.69, P = 0.02, respectively). Post-estimation Wald tests confirmed the negative associations with marijuana DUI were greater in magnitude for safety perceptions than knowledge of DUI laws. Increased perceptions that driving while high is unsafe was associated with significantly lower willingness to drive after using marijuana while increased knowledge of marijuana DUI laws was not associated with these outcomes.

Conclusions

Despite recent interventions targeting public awareness of the legal consequences of marijuana DUI, our results suggest that knowledge of these laws is a weaker predictor of DUI behavior than perceptions that driving high is unsafe. In addition, safety perceptions predict decreased openness to driving high while knowledge of DUI laws was not associated with openness. These findings suggest that interventions for reducing the incidence of marijuana DUI are likely to be more successful by targeting safety perceptions related to marijuana DUI rather than knowledge of DUI laws. We caution that because these data are limited to an online convenience sample, results may not be generalizable beyond our sample.

Demographics among Past 30-Day Marijuana Users in Colorado and Washington.

Sample Characteristic	Proportion (n = 865)
Age
18 to 24	8.7%
25 to 34	21.2%
35 to 54	38.4%
55 or older	31.8%
Gender
Male	39.7%
Female	60.4%
Race/ethnicity
White, non-Hispanic	79.3%
Black, non-Hispanic	3.4%
Hispanic	7.5%
Other, non-Hispanic	9.8%
Education
Did not graduate high school	1.6%
High school or GED	13.6%
Some college, no degree	29.4%
College degree or higher	55.4%

Driving while Under the Influence of Marijuana and Openness to Drive While High [95% confidence interval].

Behavior and Openness Outcome	Past 30-daymarijuana users(n = 865)
Percentage of marijuana users who report driving a car or other motor vehicle while high or feeling the effect of marijuana or hashish in past year	43.6% [40.3–47.0]
Percentage of marijuana users who report 5 or more times in the past 30 days driving a motor vehicle within 1 hour of consuming marijuana or hashish	23.9% [20.3–27.6]
Percentage of marijuana users who agree or strongly agree that “I might drive high even though I know I shouldn’t.”	52.7% [49.3–56.1]
Percentage of marijuana users who agree or strongly agree that “In certain situations, I might drive high.”	41.3% [37.9–44.6]

Full article at:   http://goo.gl/1xbERp

By:  Kevin C. Davis,^* Jane Allen, Jennifer Duke, James Nonnemaker, Brian Bradfield, Matthew C. Farrelly, Paul Shafer, andScott Novak

Giuseppe Remuzzi, Editor

RTI International, Research Triangle Park, NC, United States of America

Mario Negri Institute for Pharmacological Research and Azienda Ospedaliera Ospedali Riuniti di Bergamo, ITALY

Competing Interests: The authors have declared that no competing interests exist.

Analyzed the data: BB PS. Wrote the paper: KCD JA JD JN BB MCF PS SN.

* E-mail: gro.itr@sivadck

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

What Do We Know Now About the Impact of the Laws Related to Marijuana?

OBJECTIVES:

This study presents information on the status and impact of medical and legalized marijuana, and the latest data on attitudes and prevalence of use since implementation of these laws. Recent reports from epidemiologists in Denver and Seattle are summarized to give the readers a sense of the changes as these laws have taken effect in their communities.

METHODS:

The status of these laws is reviewed and the results of surveys taken before and after the laws were enacted are presented, along with data on changing potency and driving under the influence of marijuana.

SUMMARY:

Prevalence of use by youths has not increased, but their negative attitudes towards the risk of using marijuana have decreased, and use by adults has increased. Potency continues to increase, as has the proportion of drivers testing positive for use of the drug. Data from Denver show increases in hospital admissions, emergency department visits, and calls to poison centers, with decreasing arrests and admissions to substance abuse treatment programs. Data from the Seattle area show similar decreases in treatment admissions and police involvement, but also increased prevalence of more frequent use.

CONCLUSIONS:

Current data suggest that increases in marijuana use preceded legalization in 2012. Treatment admissions were declining before these laws, but some indicators of morbidity seem to be increasing subsequent to legalization, with modest increases in poison center calls in both states and increases in acute medical visits in Denver. Data are needed to understand the relationship between the patterns and amounts of use in terms of consequences, and data on the health conditions of those receiving medical marijuana and the impact of higher potency.

Purchase full article at:  http://goo.gl/vHeIXf

By:  Maxwell JC1, Mendelson B.

• 1Center for Social Work Research (JCM); Denver Office of Drug Strategy, 1200 Federal Boulevard, Denver, Colorado (BM). 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Alcohol Use and Firearm Violence

Although the misuse of firearms is necessary to the occurrence of firearm violence, there are other contributing factors beyond simply firearms themselves that might also be modified to prevent firearm violence. Alcohol is one such key modifiable factor. 

To explore this, we undertook a 40-year (1975-2014) systematic literature review with meta-analysis. One large group of studies showed that over one third of firearm violence decedents had acutely consumed alcohol and over one fourth had heavily consumed alcohol prior to their deaths. 

Another large group of studies showed that alcohol was significantly associated with firearm use as a suicide means. Two controlled studies showed that gun injury after drinking, especially heavy drinking, was statistically significant among self-inflicted firearm injury victims. 

A small group of studies investigated the intersection of alcohol and firearms laws and alcohol outlets and firearm violence. One of these controlled studies found that off-premise outlets selling takeout alcohol were significantly associated with firearm assault. 

Additional controlled, population-level risk factor and intervention studies, including randomized trials of which only 1 was identified, are needed. 

Policies that rezone off-premise alcohol outlets, proscribe blood alcohol levels and enhance penalties for carrying or using firearms while intoxicated, and consider prior drunk driving convictions as a more precise criterion for disqualifying persons from the purchase or possession of firearms deserve further study.

Purchase full article at:   http://goo.gl/ZIxMts

By:  Branas CC, Han S, Wiebe DJ.

Correspondence to Dr. Charles C. Branas, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104 (e-mail: cbranas@upenn.edu).

Epidemiol Rev. 2016 Jan 24. pii: mxv010. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Correlates of Marijuana Drugged Driving and Openness to Driving While High: Evidence from Colorado and Washington

Aims 

A potential unintended consequence of legalizing recreational marijuana is increased marijuana-related driving impairment. Some states where recreational marijuana is legal have begun implementing interventions to mitigate driving under the influence (DUI) of marijuana, including media campaigns to increase knowledge about DUI laws. However, little is known about the associations between knowledge of DUI laws and marijuana DUI behavior. In this study, we provide new data from a survey of marijuana users in Colorado and Washington to examine associations between marijuana drugged driving and two potential behavioral precursors of marijuana DUI. We also explore other factors that may influence marijuana DUI.

Methods

Data are from an online survey of marijuana users in Colorado and Washington. Respondents who reported any marijuana use in the past 30 days (n = 865) served as the analytic sample. We examined prevalence of two behavioral outcomes: (1) any driving of a motor vehicle while high in the past year and (2) driving a motor vehicle within 1 hour of using marijuana 5 or more times in the past month. Additional outcomes measuring willingness to drive while high were also assessed. Logistic regressions were used to estimate each outcome as a function of two multi-item scales measuring knowledge of the legal consequences of driving high and perceptions that driving while high is not safe. Additional covariates for potential confounders were included in each model.

Results

Prevalence of past-year driving while under the influence of marijuana was 43.6% among respondents. The prevalence of driving within 1 hour of using marijuana at least 5 times in the past month was 23.9%. Increased perception that driving high is unsafe was associated with lower odds of past-year marijuana DUI (OR = 0.31, P < 0.01) and lower past-month odds of driving 5 or more times within 1 hour of using marijuana (OR = 0.26, P < 0.01). Increased knowledge of marijuana DUI laws was also associated with lower odds of each of these outcomes (OR = 0.63, P < 0.01, OR = 0.69, P = 0.02, respectively). Post-estimation Wald tests confirmed the negative associations with marijuana DUI were greater in magnitude for safety perceptions than knowledge of DUI laws. Increased perceptions that driving while high is unsafe was associated with significantly lower willingness to drive after using marijuana while increased knowledge of marijuana DUI laws was not associated with these outcomes.

Conclusions

Despite recent interventions targeting public awareness of the legal consequences of marijuana DUI, our results suggest that knowledge of these laws is a weaker predictor of DUI behavior than perceptions that driving high is unsafe. In addition, safety perceptions predict decreased openness to driving high while knowledge of DUI laws was not associated with openness. These findings suggest that interventions for reducing the incidence of marijuana DUI are likely to be more successful by targeting safety perceptions related to marijuana DUI rather than knowledge of DUI laws. We caution that because these data are limited to an online convenience sample, results may not be generalizable beyond our sample.

Below:  Driving while Under the Influence of Marijuana and Openness to Drive While High

Full article at:  http://goo.gl/fzgF4t

By:  Kevin C. Davis, Jane Allen, Jennifer Duke, James Nonnemaker, Brian Bradfield, Matthew C. Farrelly, Paul Shafer, Scott Novak

RTI International, Research Triangle Park, NC, United States of America

  

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Combined Use of Alcohol and Energy Drinks Increases Participation in High-Risk Drinking and Driving Behaviors among College Students

Objective:

A recent study suggested that college students who combined alcohol and energy drinks were more likely than students who consumed only alcohol to drive when their blood alcohol concentration (BAC) was higher than the .08% limit and to choose to drive despite knowing they had too much alcohol to drive safely. This study sought to replicate those findings with a larger sample while also exploring additional variables related to impaired driving.

Method:

College students (N = 549) completed an anonymous online survey to assess differences in drinking and driving-related behaviors between alcohol-only users (n = 281) and combined alcohol-energy drink users (n = 268).

Results:

Combined users were more likely than alcohol-only users to choose to 

1. drive when they perceived they were over the .08% BAC limit,
2. drive despite knowing they had too much alcohol to drive safely, and 
3. be a passenger when they knew the driver had too much alcohol to drive safely. 

Combined users were significantly more likely to report indicators of high-risk alcohol use, such as larger number of drinks consumed, number of days drinking, number of days drunk, number of heavy episodic drinking episodes, greatest number of drinks on one occasion, and average hours of consumption.

Conclusions:

Combined use of alcohol and energy drinks may place drinkers at greater risk when compared with those who consume only alcohol. College students in this sample who combined alcohol and energy drinks were more likely to participate in high-risk driving behaviors than those who consumed only alcohol.

Purchase full article at:   http://goo.gl/jKGGRi

By:   Conrad L. Woolsey, Ph.D.,^a* Ronald D. Williams, Ph.D.,^b Jeff M. Housman, Ph.D.,^b Adam E. Barry, Ph.D.,^c Bert H. Jacobson, Ph.D.,^d & Marion W. Evans, D.C., Ph.D.^a

Affiliations
^aNorthwest Center for Lifestyle and Functional Medicine, University of Western States, Portland, Oregon
^bDepartment of Health and Human Performance, Texas State University, San Marcos, Texas
^cDepartment of Health & Kinesiology, Texas A&M University, College Station, Texas
^dDepartment of Health and Human Performance, Oklahoma State University, Stillwater, Oklahoma

*Correspondence may be sent to Conrad L. Woolsey at the Northwest Center for Lifestyle and Functional Medicine, University of Western States, 2900 NE 132nd Avenue, Portland, OR 97230, or via email at: cwoolsey@uws.edu.

DOI: http://dx.doi.org/10.15288/jsad.2015.76.615 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Relationships Between Minimum Alcohol Pricing and Crime During the Partial Privatization of a Canadian Government Alcohol Monopoly

Objective:

The purpose of this study was to estimate the independent effects of increases in minimum alcohol prices and densities of private liquor stores on crime outcomes in British Columbia, Canada, during a partial privatization of off-premise liquor sales.

Method:

A time-series cross-sectional panel study was conducted using mixed model regression analysis to explore associations between minimum alcohol prices, densities of liquor outlets, and crime outcomes across 89 local health areas of British Columbia between 2002 and 2010. Archival data on minimum alcohol prices, per capita alcohol outlet densities, and ecological demographic characteristics were related to measures of crimes against persons, alcohol-related traffic violations, and non–alcohol-related traffic violations. Analyses were adjusted for temporal and regional autocorrelation.

Results:

A 10% increase in provincial minimum alcohol prices was associated with an 18.81% reduction in alcohol-related traffic violations, a 9.17% reduction in crimes against persons, and a 9.39% reduction in total rates of crime outcomes examined. There was no significant association between minimum alcohol prices and non–alcohol-related traffic violations. Densities of private liquor stores were not significantly associated with alcohol-involved traffic violations or crimes against persons, though they were with non–alcohol-related traffic violations.

Conclusions:

Reductions in crime events associated with minimum-alcohol-price changes were more substantial and specific to alcohol-related events than the countervailing increases in densities of private liquor stores. The findings lend further support to the application of minimum alcohol prices for public health and safety objectives.

Purchase full article at:   http://goo.gl/hqaTox

By:   Tim Stockwell, Ph.D.,^a,b,* Jinhui Zhao, Ph.D.,^a Miesha Marzell, Ph.D.,^c Paul J. Gruenewald, Ph.D.,^d Scott Macdonald,Ph.D.,^a,e William R. Ponicki, M.A.,^d & Gina Martin, M.Sc.^f

Affiliations

^aCentre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada
^bDepartment of Psychology, University of Victoria, Victoria, British Columbia, Canada
^cDepartment of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa
^dPrevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
^eSchool of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
^fSchool of Medicine, University of St. Andrews, St. Andrews, Scotland

*Correspondence may be sent to Tim Stockwell at the Centre for Addictions Research of British Columbia, University of Victoria, P.O. Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada, or via email at: timstock@uvic.ca.

DOI: http://dx.doi.org/10.15288/jsad.2015.76.628 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Dilemma of Re-Licensing DWI Offenders: The Offenders' Point of View

In many jurisdictions, drivers convicted for the first-time of driving while impaired by alcohol undertake a risk assessment that will determine the severity of sanctions and the remedial measures they must follow as requisites for re-licensing. There is uncertainty inherent in the assessment of risk for recidivism, however, many offenders feel unfairly assessed and discommoded by the decision-making process and its consequences. 

The objective of this qualitative study was to gain insight into the perspectives of offenders regarding re-licensing decision making and sanctioning. Specifically, in focus groups first-time offenders and recidivists were probed as to whether they favoured erring on the side of road safety in decision making, with its consequent greater risk of false positive assessments, or erring on the side of maintaining driving privileges, with its consequent greater risk of false negative assessments. 

In general, participants preferred a higher probability of false negative vs. false positive assessments. Most cited the consequences of sanctions and remedial measures as too severe to impose them on potentially low-risk drivers, as the assessment and monitoring protocols' limitations could lead to non-equitable treatment. At the same time, recidivists evoked a greater preference for a higher probability of false positive assessments compared to first-time offenders, as they believed that recidivism was more likely to follow a first conviction than did first-time offenders. 

This information can be useful for a more comprehensive and societally coherent exercise of DWI prevention policies.

Purchase full article at:   http://goo.gl/EB0RiC

By:   Nadeau L1, Vanlaar W2, Jarvis J3, Brown TG4.

• 1Department de Psychologie, Université de Montréal, Montréal, Québec, Canada.
• 2Traffic Injury Research Foundation, Ottawa, Ontario, Canada.
• 3Research Centre of the Douglas Mental Health University Institute, Verdun, Québec, Canada.
• 4Research Centre of the Douglas Mental Health University Institute, Verdun, Québec, Canada; Department of Psychiatry, McGill University, Montreal, Québec, Canada; Foster Addiction Rehabilitation Centre, St. Philippe de Laprairie, Québec, Canada. Electronic address: thomas.brown@mcgill.ca. 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health

Percentage of persons who reported driving a vehicle under the influence of alcohol alone, marijuana alone, and alcohol and marijuana combined in the past year by age (years)

Percentage of persons who reported driving a vehicle under the influence of alcohol alone, marijuana alone,* and alcohol and marijuana* combined in the past year by age (years) — National Survey on Drug Use and Health, United States, 2014

Motor vehicle accidents are the leading cause of death among youths and young adults aged 16–25 years in the United States (1). The prevalence of drinking and driving among high school students aged 16–19 years has declined by 54%, from 22.3% in 1991 to 10.3% in 2011 (2). However, the prevalence of weekend nighttime driving under the influence of marijuana (based on biochemical assays) among drivers aged ≥16 years has increased by 48%, from 8.6% in 2007 to 12.6% in 2013–2014 (3). Use of marijuana alone and in combination with alcohol has been shown to impair driving abilities (4–9). This report provides the most recent self-reported national estimates of driving under the influence of alcohol, marijuana, and alcohol and marijuana combined among persons aged 16–25 years, using data from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) from 2002–2014. Prevalence data on driving under the influence of both substances were examined for two age groups (16–20 years and 21–25 years) and by sex and race/ethnicity. During 2002–2014, the prevalence of driving under the influence of alcohol alone significantly declined by 59% among persons aged 16–20 years (from 16.2% in 2002 to 6.6% in 2014; p<0.001) and 38% among persons 21–25 years (from 29.1% in 2002 to 18.1% in 2014; p<0.001). In addition, the prevalence of driving under the influence of alcohol and marijuana combined significantly declined by 39%, from 2.3% in 2002 to 1.4% in 2014 (p<0.001) among persons aged 16–20 years and from 3.1% in 2002 to 1.9% in 2014 (p<0.001) among persons aged 21–25 years. The prevalence of driving under the influence of marijuana alone declined 18%, from 3.8% in 2002 to 3.1% in 2014 (p = 0.05) only among persons aged 16–20 years. Effective public safety interventions,* such as minimum legal drinking age laws, prohibition of driving with any alcohol level >0 for persons aged <21 years, targeted mass media campaigns, roadside testing (e.g., sobriety checkpoints), and graduated driver licensing programs (10) have contributed to the decline in driving under the influence of alcohol in this population. These or similar interventions might be useful to prevent driving under the influence of other substances, such as marijuana alone or combined with other substances.

Via: http://ht.ly/VJxAP 

Percentage of Persons Who Reported Driving a Vehicle Under Influence of Alcohol and/or Marijuana

Percentage of persons who reported driving a vehicle under the influence of alcohol alone, marijuana alone, and alcohol and marijuana combined in the past year among persons aged 16–20 years and persons aged 21–25 years — National Survey on Drug Use and Health, United States, 2002–2014

Motor vehicle accidents are the leading cause of death among youths and young adults aged 16–25 years in the United States (1). The prevalence of drinking and driving among high school students aged 16–19 years has declined by 54%, from 22.3% in 1991 to 10.3% in 2011 (2). However, the prevalence of weekend nighttime driving under the influence of marijuana (based on biochemical assays) among drivers aged ≥16 years has increased by 48%, from 8.6% in 2007 to 12.6% in 2013–2014 (3). Use of marijuana alone and in combination with alcohol has been shown to impair driving abilities (4–9). This report provides the most recent self-reported national estimates of driving under the influence of alcohol, marijuana, and alcohol and marijuana combined among persons aged 16–25 years, using data from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) from 2002–2014. Prevalence data on driving under the influence of both substances were examined for two age groups (16–20 years and 21–25 years) and by sex and race/ethnicity. During 2002–2014, the prevalence of driving under the influence of alcohol alone significantly declined by 59% among persons aged 16–20 years (from 16.2% in 2002 to 6.6% in 2014; p<0.001) and 38% among persons 21–25 years (from 29.1% in 2002 to 18.1% in 2014; p<0.001). In addition, the prevalence of driving under the influence of alcohol and marijuana combined significantly declined by 39%, from 2.3% in 2002 to 1.4% in 2014 (p<0.001) among persons aged 16–20 years and from 3.1% in 2002 to 1.9% in 2014 (p<0.001) among persons aged 21–25 years. The prevalence of driving under the influence of marijuana alone declined 18%, from 3.8% in 2002 to 3.1% in 2014 (p = 0.05) only among persons aged 16–20 years. Effective public safety interventions,* such as minimum legal drinking age laws, prohibition of driving with any alcohol level >0 for persons aged <21 years, targeted mass media campaigns, roadside testing (e.g., sobriety checkpoints), and graduated driver licensing programs (10) have contributed to the decline in driving under the influence of alcohol in this population. These or similar interventions might be useful to prevent driving under the influence of other substances, such as marijuana alone or combined with other substances.

Via: http://ht.ly/VJxAP 

Relationship of Aggression, Negative Affect, Substance Use Problems & Childhood Delinquency to DWI Recidivism

BACKGROUND:

Driving under the influence remains a pervasive problem. Approximately 30% of those arrested for impaired driving offenses each year are repeat offenders, suggesting that current rehabilitative efforts are not sufficiently effective for reducing driving while intoxicated (DWI) recidivism. Aggression, negative affect, substance use problems, and childhood delinquency have been noted in the population of impaired drivers, but study of these variables on recidivism has been limited.

OBJECTIVES:

The aim of the current study was to examine the effects of aggression, negative affect, substance use problems, and childhood delinquency on DWI recidivism among first time offenders.

METHODS:

In 1992, 6436 individuals in impaired driver programs in New York State were surveyed. A total of 3511 individuals provided names so that state driver abstracts could be reviewed in the future. A total of 2043 matches were found and 1770 remained after excluding those with previous DWI convictions. Driver records were reviewed in 2010 and 2012, providing between 18 and 20 years of follow-up.

RESULTS:

During the follow-up period, 16.5% of individuals were arrested for an impaired driving offense. Multivariate analysis suggested that recidivism was a function of several problems, including: alcohol problem severity, aggression, negative affect, drug problem severity, criminal history, and childhood delinquency.

CONCLUSION:

Impaired driving programs should assess for childhood delinquency, aggressive tendencies, and negative affect as these constructs, along with substance use, are evident among impaired drivers who recidivate. Interventions addressing aggression and negative affect may ultimately prove useful in reducing recidivism.

Purchase full article at:   http://goo.gl/xyRcBH

By:  Linn BK1, Nochajski T1, Wieczorek W2.

• 1 School of Social Work , University at Buffalo, The State University of New York , Amherst , NY , USA.
• 2 Buffalo State College , Buffalo , NY , USA. 

More at:  https://twitter.com/hiv_insight

And:        http://twitter.com/Prison_Health

Identifying Classes of Conjoint Alcohol and Marijuana Use in Entering Freshmen

The current study identified classes of conjoint marijuana and alcohol use in entering college freshmen using latent profile analysis (N = 772; 53% male, 60% White; Mage = 18). 

Results yielded 4 distinct groups: 

• Class 1 (moderate drinking with recent marijuana use: 22% of sample), 
• Class 2 (moderate drinking with no recent marijuana use: 25%), 
• Class 3 (light drinking with no recent marijuana use: 40%) and 
• Class 4 (heavy drinking with recent marijuana use: 14%). 

Separate pairwise contrasts examined cross-class differences in demographics and drinking behaviors, comparing differences in drinking when current marijuana use was controlled (Class 1 vs. 4) and differences in marijuana use when drinking was held relatively constant (Class 1 vs. 2). 

Among moderate drinkers, recent marijuana users were more likely to drink more than intended, drink to get drunk, and had more problems (including higher rates of blackouts, physical injury, and DUI) relative to peers who refrained from marijuana. No cross-class differences were found for alcohol expectancies or behavioral motives. 

Findings from these analyses show the presence of distinct groups of conjoint users with different drinking behaviors and consequence profiles, and suggest that conjoint alcohol-marijuana use may be more problematic overall than single substance involvement and highlight the need for developing campus prevention and intervention programs that address the increased risk from polysubstance involvement.

Via: http://ht.ly/Ss9d0 Purchase full article at: http://goo.gl/L3aFWm

By: Haas AL, Wickham R, Macia K, Shields M, Macher R, Schulte T.