Trends and correlates of driving under the influence of alcohol among different types of adult substance users in the United States: a national survey study.
Abstract
BACKGROUND:Despite a decrease in driving under the influence of alcohol (DUIA) prevalence
over the past decades, DUIA prevalence still remains high in the United States. To
date, there is limited research examining whether different types of substance users
have different trends in DUIA. This study sought to assess trends and variables associated
with DUIA by substance use type. METHODS:National Survey on Drug Use and Health (NSDUH)
is a cross-sectional, nationally representative population-based survey. By using
the NSDUH 2008-2014, we performed the Joinpoint analysis to identify time trends of
DUIA in each group of substance users (aged ≥18 years). Logistic regression analysis
was used to explore association between substance use type and DUIA and to identify
variables associated with DUIA. RESULTS:Adults who reported alcohol or drug use in
the past year were classified into different groups based on past-year substance use
status: alcohol use only (n = 141,521) and drug use regardless alcohol use. Drug users
included prescription opioids only (n = 5337), marijuana only (n = 32,206), other
single drug (n = 3789), prescription opioids-marijuana (n = 3921), multiple prescription
drugs (n = 1267), and other multiple drugs (n = 18,432). The Joinpoint analysis showed
that DUIA prevalence decreased significantly from 2008 to 2014 among alcohol only
users (Average Annual Percent Change [AAPC] = - 2.8), prescription opioids only users
(AAPC = -5.4), marijuana only users (AAPC = -5.0), prescription opioids-marijuana
users (AAPC = -6.5), multiple prescription drug users (AAPC = -7.4), and other multiple
drug users (AAPC = -3.2). Although the estimate was not statistically significant,
other single drug users showed a decreasing trend (AAPC = -0.9). Substance use type
was significantly associated with DUIA in the adjusted logistic regression. All drug
use groups, relative to the alcohol only group, had elevated odds of DUIA, and the
odds were especially elevated for the multiple drug use groups (prescription opioids-marijuana,
adjusted odds ratio [AOR] = 2.71; multiple prescription drugs, AOR = 2.83; and other
multiple drugs, AOR = 3.68). Additionally, younger age, male sex, being white, higher
income, and alcohol abuse/dependence were positively associated with DUIA. CONCLUSIONS:DUIA
prevalence decreased over time and the magnitude of this reduction differed by substance
use type. DUIA interventions need to be tailored to substance use type and individual
characteristics.
Type
Journal articleSubject
HumansSubstance-Related Disorders
Alcoholism
Health Surveys
Prevalence
Logistic Models
Cross-Sectional Studies
Alcohol Drinking
Adolescent
Adult
Middle Aged
United States
Female
Male
Drug Users
Prescription Drugs
Driving Under the Influence
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https://hdl.handle.net/10161/19920Published Version (Please cite this version)
10.1186/s12889-019-6889-8Publication Info
Park, Ji-Yeun; Park, Ji-Yeun; & Wu, Li-Tzy (2019). Trends and correlates of driving under the influence of alcohol among different types
of adult substance users in the United States: a national survey study. BMC public health, 19(1). pp. 509. 10.1186/s12889-019-6889-8. Retrieved from https://hdl.handle.net/10161/19920.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder

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