Estimating the Prevalence of Alcohol Use Disorders among At-Risk Drivers

描述（由申请人提供）：本提案旨在对即将进行的2006年国家公路安全和交通管理局（NHSTA）全国道路调查（NRS）的大约6,000名参与者实施酒精使用障碍（AUDs）的简短筛选。有大量证据表明，重度饮酒者和问题饮酒者在酒后驾车违规者中所占比例过高，对高速公路和交通安全构成了重大威胁。建议在即将到来的NRS中纳入一种简短的AUD筛选器，用于快速路边评估AUD。该项目将澄清一般驾驶员，特别是通过标准化呼吸测试测得血液酒精含量升高的驾驶员目前存在酒精问题的程度。如果成功，该筛查将有助于决策者确定对酒后驾车违法者的适当干预服务，并将横断面BAG读数与不同类型的病理酒精使用（即酗酒、重度饮酒和酒精滥用和依赖）相关联（未满足治疗需求的潜在信号）。建议在这次大型路边调查中使用的酒精筛查基于现有证据，这些证据来自一个探索性项目，该项目对筛查器进行了改进、试点和验证，使其成为一种快速的路边筛查工具。采用的测量结构为酒精使用障碍识别测试（AUDIT）的消费子量表和酒精使用障碍与相关残疾访谈表（AUDADIS）。这项工作分为三个不同的阶段。第一阶段需要为全国人口登记系统的6 000个病例进行准备。第二阶段是NRS项目的实地调查，第三阶段致力于数据分析和研究结果的传播。这项工作的具体目的是：目的1：评估酒精使用障碍（AUDs）患者在夜间周末驾驶人群中的存在程度，这是酒精相关车祸死亡风险最高的时期。目标2;评估横截面BAG与活动性AUD状态之间的关系，包括对活动性其他药物使用的调整。目的3：确定夜间周末司机的特征，这些特征表明未满足药物和酒精相关预防或干预服务的治疗需求。健康意义：这项工作的意义最好是考虑到大量的社会资源正在分配，以解决被认为是长期酒后驾车罪犯的澳大利亚司机所带来的感知风险，这一点得到了州法律通过的证明。这一全国性概率样本将使我们能够估计出患有aud的人在车祸、伤害和死亡风险最高的驾驶和乘客群体中所占的比例。

DESCRIPTION (provided by applicant): This proposal seeks to implement a brief screen for alcohol use disorders (AUDs) among the approximate 6,000 participants in the upcoming 2006 National Highway Safety and Traffic Administration (NHSTA) National Roadside Survey (NRS). There is a body of evidence that purports heavy and problem drinkers are overrepresented in the population of DUI offenders and pose a significant threat to highway and traffic safety. A brief AUD screener validated as rapid roadside assessment of AUDs is proposed for inclusion in the upcoming NRS. This project will clarify the extent to which drivers in general, and more specifically drivers with elevated blood alcohol contents as measured by standardized breath tests have current alcohol problems. If successful, this screen will aid policymakers in determining appropriate intervention services for DUI offenders as well as correlate cross-sectional BAG readings with varying types of pathological alcohol use, namely binge drinking, heavy drinking, and alcohol abuse and dependence (potential signals for unmet treatment need). The alcohol screen proposed for use in this large roadside survey is grounded in existing evidence derived from and exploratory program where the screener was refined, piloted and validated as a rapid roadside screening tool. The measurement constructs to be employed are the consumption subscale of the Alcohol Use Disorders Identification Test (AUDIT) and the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS). This work is divided into three distinct phases. Phase 1 entails preparation for the 6,000 case fielding of the NRS. Phase 2 is the fielding of the NRS Program and Phase 3 is dedicated to analysis of data and dissemination of findings. The specific aims of this work are: Aim 1: To assess the extent to which persons with alcohol-use disorders (AUDs) are present in the nighttime weekend driving population, the period of greatest risk for alcohol-related crash fatalities. Aim 2; To conduct an assessment of the relationship between cross-sectional BAG and active AUD status, including adjustment for active other drug use. Aim 3: To identify characteristics of nighttime weekend drivers that signal unmet treatment need for drug- and alcohol-related prevention or intervention services. Health significance: The significance of this work is best viewed in light of the substantial societal resources being allocated to address the perceived risk posed by AUD drivers who are believed to be chronic DUI offenders as evidenced by the passage of state laws. This nationwide probability sample will enable national prevalence estimates of the extent to which persons with AUDs are represented in the most at-risk for crash, injury and death driving and passenger population.