Self-Efficacy to Drive While Intoxicated: Insights into the Persistence of Alcohol-Impaired Driving

Measuring subjective alcohol effects in daily life using contemporary young adult language

Young adults' subjective feelings of alcohol's effects are a key predictor of engagement in risky behavior such as deciding whether to drive after drinking. To best inform prevention messaging and tailor intervention techniques that target high-risk drinking, it is critical that our measurement best captures subjective feelings. Standard sliding scales (0-100 rating of, "how drunk do you feel?") may have some challenges with distinguishing between levels of subjective responses to alcohol. The current daily diary study compared the utility of the standard sliding scale to a newly developed sliding scale that uses contemporary, crowd-sourced language from young adults as evenly spaced anchors (slightly buzzed, tipsy/"happy," drunk, and wasted) along a continuum of subjective effects of alcohol. Participants were 154 young adult substance users (58% women) who completed up to 14 consecutive daily reports of their substance use behavior. The four-anchored sliding scale performed similarly well as the standard scale in predicting alcohol use outcomes while showing the advantages of recording higher mean values/standard deviations and demonstrating that participants used the anchors to denote varying degrees of subjective effects. Findings suggest that the four-anchored subjective alcohol effects sliding scale is a viable alternative to the standard scale. By providing evenly spaced anchors that reflect incremental differences in language young adults use to describe their subjective states, the proposed scale may provide a guide for participants to indicate how they feel after drinking and may better capture variability in alcohol's effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Concerts, bars, parties, and raves: Differential risk for drug use among high school seniors according to venue attendance

Background: Nightlife attendance is an established risk factor for drug use, but studies have not focused on adolescent general population samples or compared risk according to type(s) of venues attended. We examined whether attendance of various types of venues was associated with drug use. Methods: Data were examined from an annual nationally representative survey of high school seniors in the US (2014-2019, N = 11,565). We determined whether past-year attendance of parties, concerts, bars or nightclubs, and raves or dance music events was associated with past-year drug use using mixed-effects logistic regression. Mall and movie attendance were examined as negative controls. Results: Compared to those who reported not attending specific venues, attending parties was associated with higher odds of using alcohol in particular (aOR = 5.03, 95% CI: 3.92-6.44). Attending concerts was associated with higher odds for use of alcohol, cannabis, ecstasy, and nonmedical use of prescription stimulants and opioids. All drugs examined were concentrated among those who attend bars, nightclubs, raves, and dance parties. Rave or dance party attendance was associated with higher odds for use of ecstasy (aOR = 3.71, 95% CI: 2.50-5.50) and methamphetamine (aOR = 4.92, 95% CI: 2.43-9.96) in particular, and bar or nightclub attendance was associated with higher odds of use of cocaine (aOR = 6.49, 95% CI: 4.37-9.63), ecstasy (aOR = 6.49, 95% CI: 4.54-9.27), and methamphetamine (aOR = 5.49, 95% CI: 2.57-11.72) in particular. Attending movies was associated with lower odds for use of cocaine and nonmedical prescription stimulant use. Conclusion: We determined differential risk of drug use depending on types of venues attended by adolescents.

The hazardous (mis)perception of Self-estimated Alcohol intoxication and Fitness to drivE-an avoidable health risk: the SAFE randomised trial

BACKGROUND

Worldwide, alcohol-related road traffic accidents represent a major avoidable health risk. The aim of this study was to evaluate the accuracy of self-estimating the degree of acute alcohol intoxication regarding the legal driving limit, and to identify risk factors for misjudgement.

METHODS

In this prospective randomised controlled crossover trial, 90 social drinkers (mean age 23.9 ± 3.5 years, 50% female) consumed either beer or wine. Study group subjects were made aware when exceeding the legal driving limit (BrAC = 0.05%). Controls received no information about their BrAC. For crossover, beer or wine were consumed in the opposite order.

RESULTS

39-53% of all participants exceeded the legal driving limit whilst under the impression to be still permitted to drive. Self-estimation was significantly more accurate on study day 2 (p = 0.009). Increasing BrAC positively correlated with self-estimation inaccuracy, which was reproducible during crossover. Multiple regression analysis revealed fast drinking and higher alcohol levels as independent risk factors for inaccurate self-estimation.

CONCLUSIONS

Social drinkers are commonly unaware of exceeding the legal driving limit when consuming alcohol. Self-estimating alcohol intoxication can be improved through awareness. Dedicated awareness programs, social media campaigns and government advice communications should be utilised to address this avoidable hazard. Trial registration The trial was registered prospectively at the Witten/Herdecke University Ethics Committee (trial registration number 140/2016 on 04/11/2016) and at the DRKS-German Clinical Trials Register (trial registration number DRKS00015285 on 08/22/2018-Retrospectively registered). Trial protocol can be accessed online.

Pregaming: A Field-Based Investigation of Alcohol Quantities Consumed Prior to Visiting a Bar and Restaurant District

BACKGROUND

Investigations examining the association between pregaming, or the consumption of alcohol prior to attending a social gathering or drinking establishment, and blood alcohol concentrations have primarily relied on estimations (i.e., Widmark equation), rather than objective biologic samples, such as breath alcohol concentration (BrAC).

OBJECTIVES

The current study assessed: (1) pregaming, using quantity-based measures, among a sample of college and non-college affiliated bar patrons, (2) associations between pregaming intensity/status and participant intoxication (BrAC), and (3) whether participants who pregamed were more likely to identify as a hazardous drinker.

METHODS

548 bar patrons provided data on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and a single pregaming item assessing quantity of alcohol consumed prior to visiting a bar/restaurant district in 2015. BrAC samples were collected post interview. We used hierarchical linear regression models, respectively, to assess whether pregaming significantly impacted BrAC and whether presence of hazardous drinking predicted pregaming behavior.

RESULTS

After controlling for sex, race/ethnicity, age, student status, and Greek affiliation, the linear regression model explained 32.3% (R² = .323) of the variance of BrAC levels (F(12) = 21.162, p < .001), with 4.30% of the variance explained solely by pregaming (β = 0.014; p < .001). The linear regression model to assess if harzardous drinking behavior (AUDIT-C) significantly predicted pregaming explained 31.2% (R² = .312) of the variance of pregaming behavior (F(18) = 13.276, p < .001), with 4.2% of the variance explained solely by AUDIT-C scores (β = 0.280; p < .001).

CONCLUSION

Findings further highlight pregaming as a harmful risk behavior linked to elevated levels of hazardous drinking and intoxication.

Risk factors for adverse driving outcomes in Dutch adults with ADHD and controls

OBJECTIVE

To identify risk factors for adverse driving outcomes and unsafe driving among adults with and without ADHD in a Dutch sample.

METHODS

In this cross-sectional study, validated self-report questionnaires were used to compare driving history and current driving behavior between 330 adults diagnosed with ADHD and 330 controls.

RESULTS

Adults with ADHD had significantly more adverse driving outcomes when compared to controls. Having an ADHD diagnosis significantly increased the odds for having had 3 or more vehicular crashes (OR = 2.72; p = .001). Driving frequency, male gender, age, high anxiety levels, high hostility levels, and alcohol use all significantly influenced the odds for unsafe driving behavior, for having had 12 or more traffic citations, and/or for having had 3 or more vehicular crashes.

CONCLUSIONS

Alcohol use, and high levels of anxiety and hostility are highly prevalent among adults with ADHD, and they mediate the risk for negative driving outcomes in this group.

Examining the social ecology of a bar-crawl: An exploratory pilot study

Many of the problems associated with alcohol occur after a single drinking event (e.g. drink driving, assault). These acute alcohol problems have a huge global impact and account for a large percentage of unintentional and intentional injuries in the world. Nonetheless, alcohol research and preventive interventions rarely focus on drinking at the event-level since drinking events are complex, dynamic, and methodologically challenging to observe. This exploratory study provides an example of how event-level data may be collected, analyzed, and interpreted. The drinking behavior of twenty undergraduate students enrolled at a large Midwestern public university was observed during a single bar crawl event that is organized by students annually. Alcohol use was monitored with transdermal alcohol devices coupled with ecological momentary assessments and geospatial data. “Small N, Big Data” studies have the potential to advance health behavior theory and to guide real-time interventions. However, such studies generate large amounts of within subject data that can be challenging to analyze and present. This study examined how to visually display event-level data and also explored the relationship between some basic indicators and alcohol consumption.

Factors Associated with Self-Estimated Breath Alcohol Concentration Among Bar Patrons

BACKGROUND

Few studies have examined the context in which drinkers underestimate their breath alcohol concentration (BrAC) in natural drinking environments. This study examined factors associated with bar patrons' self-estimated BrAC in high-risk college town settings.

METHODS

Guided interview and BrAC data were collected from 510 participants recruited as they exited bars located close to large universities: 1 in Florida and 1 in Texas.

RESULTS

Participants with the highest measured BrACs underestimated their BrAC levels the most. Findings from multivariable linear regression analysis indicated that BrAC (std β = 0.014, p < 0.001), number of alcoholic drinks consumed (std β = 0.006, p < 0.01), and perceived drunkenness (std β = 0.024, p < 0.001) had significant positive associations with BrAC self-estimates, where the regression coefficients were scaled by values approximately equal to each variable's interquartile range. Among the 321 participants with BrAC levels ≥ 0.08 g/dl, 21.2% believed their BrAC was below the legal per se driving limit of 0.08 g/dl. Results from a logistic regression analysis indicated that higher levels of perceived drunkenness were associated with better self-recognition that one's BrAC level exceeded the legal driving threshold (OR = 3.312, p < 0.001). Further, participants under 26 years of age had reduced odds of recognizing that their BrAC was greater than 0.079 g/dl (OR = 0.245, p < 0.05).

CONCLUSIONS

These findings highlight the inaccuracy of self-estimated BrAC when drinking, particularly among younger drinkers. Adjusting for BrAC, situational factors were strongly associated with self-estimated BrAC. Future research is needed to better understand how altering drinking environments may improve accuracy of BrAC self-estimates and deter driving after drinking.

Alcohol mixed with energy drink: Use may be a consequence of heavy drinking

AIMS

In recent years, studies have indicated that consumers of alcohol mixed with energy drink (AmED) are more likely to drink heavily and experience more negative consequences than consumers who avoid these beverages. Although researchers have identified a number of plausible hypotheses that explain how alcohol-energy drink co-ingestion could cause greater alcohol consumption, there has been no postulation about reverse causal relations. This paper identifies several plausible hypotheses for the observed associations between AmED consumption and greater alcohol consumption, and provides initial evidence for one such hypothesis suggesting that heavy drinking may be a determinant of AmED use.

METHOD

Data collected from 511bar patrons were used to examine the plausibility of one of the proposed hypotheses, i.e., AmED is an artifact of heavy drinking. Associations between the consumption of an assortment of alcoholic beverage types and total alcohol consumption were examined at the event-level, to assess whether AmED is uniquely related with greater alcohol consumption.

RESULTS

Increased alcohol consumption was associated with greater odds of consuming most alcoholic beverage types; this association was not unique to AmED.

CONCLUSIONS

Results support the overlooked hypothesis that AmED use is an artifact of heavy drinking. Thus, AmED consumption may be a consequence or marker of heavier drinking. Much of the existing research on alcoholic beverage types is limited in its ability to implicate any specific type of drink, including AmED, as a cause of increased alcohol consumption and related harm. More rigorous study designs are needed to examine causal relationships.