Alcohol and DUIs: Assessing the risk

Drinking and driving is a deadly combination and every year, numerous lives are lost needlessly due to this behaviour. While most individuals learn following a driving under the influence (DUI) arrest and conviction, some individuals continue to drink and drive despite punitive measures. How can we predict who is more likely to get behind the wheel after one too many? This is one of the questions researchers at the Douglas Hospital Research Centre in Montreal are addressing. In particular, they are examining the characteristics of those who repeatedly drink and drive and looking for new methods to identify who is more likely to repeat this high-risk behaviour.

“Driving under the influence of alcohol has important individual, social and health consequences,” says Thomas Brown, PhD, lead investigator and researcher at the Douglas. “The persistence of DUI behaviour makes it one of the most dangerous, yet preventable liabilities on the road. One of our long-term goals is to find better ways to predict who is more likely to get behind the wheel after drinking.”

According to Brown and colleagues, the risk for repeat DUIs is associated with several characteristics including, an alcohol use disorder, family history of alcoholism, age, gender and antisocial and risk taking tendencies. This complex web of factors makes it difficult to accurately assess DUI risk. Measurements need to be sensitive, significantly predictive, easily obtainable, inexpensive, and valid.

“We decided to focus on the stress hormone, cortisol, as a measurement of DUI risk,” says Brown. “Previous studies have demonstrated a relationship between cortisol and the array of behaviours that are similar to those linked to DUI recidivism, including resistance to alcoholism treatment. However, none have directly explored the cortisol response in relation to DUI recidivism.”

Brown’s research team looked at the relationship between salivary cortisol and DUI conviction history in a sample of 200 men convicted of one or more DUI offenses. Participants were asked to take part in a number of potentially stressful or cognitively challenging tasks including, blood taking, probing interviews, and neuropsychological testing. Salivary cortisol was measured at 30-minute intervals during the six-hour protocol. Their findings showed that salivary cortisol response was related to the frequency of past DUI convictions and that this association increased in strength with number of DUI convictions.”Our preliminary work shows a link between salivary cortisol levels and past DUI activity in repeated DUI offenders,” says Brown. “Using cortisol measurements, we were able to predict the frequency of past DUI convictions with better accuracy than we could with the self-reported measures typically used in DUI assessment. The next steps are to determine whether cortisol works as well to predict future DUI behaviour, and how to keep the individuals most likely to repeat, away from the bottle when they drive. We are currently evaluating a promising, brief intervention, to do just that.”

Brown’s study on salivary cortisol and DUI was recently published in Alcohol and Alcoholism. The Fonds de recherche sur la nature et les technologies, Ministre des Transports du Québec, Société de l’assurance automobile du Québec, and the Canadian Safety Council funded this research.

Some facts about drinking and driving:

  • In the US, traffic accidents are the leading cause of death for people between two to 33 years
  • Approximately 41 per cent of all fatal crashes involve alcohol
  • Approximately, 33 per cent of those convicted for DUI become repeat offenders
  • 35 to 40 per cent of all fatally injured drivers had a prior conviction for DUI

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