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Background Before the COVID‐19 pandemic, very little was known about the impact of social isolation on individuals’ alcohol use and misuse. This study examines how socially isolated individuals with a history of heavy drinking used alcohol during the pandemic. Methods Data for this study came from an add‐on to the Managing Heavy Drinking (MHD) longitudinal study of drivers convicted of DWI that was conducted in Erie County, New York. Pre‐COVID information (October 2019–March 2020) was augmented with a COVID‐19 questionnaire collected between July and August 2020. A total of 92 participants completed the COVID‐19 survey. Results The sample of problem drinkers showed a significant increase after the pandemic outbreak in the average number of drinking days from 1.99 to 2.49 per week (p = 0.047), but a significant decrease in the average number of drinks per drinking day, from 3.74 to 2.74 (p = 0.003). The proportion of individuals who drank more frequently was greater among those who, before the outbreak had an Alcohol Use Disorders Identification Test (AUDIT) score 8 (13%). Alcohol treatment was also associated with the frequency of drinking, with individuals who were not in alcohol treatment showing a 16% increase in frequency compared with a 10% increase among those in treatment. Further, individuals who, after the outbreak worried about their health (30%) or finances (37%) reported greater increases in the frequency of drinking than those who did not worry about their health (17%) or finances (10%). Conclusions Overall, the individuals in our sample showed small changes in the frequency andheaviness of drinking after the outbreak of COVID‐19, effects that opposite in direction from one another and thus resulted in no overall change in drinks consumed. Nonetheless, we identified factors that influenced the effects of the pandemic ond rinking behavior among individuals convicted of DWI, which emphasizes the need to individualize these individuals’ treatment, particularly in the context of dramatic environmental change.

BACKGROUND: Alcohol ignition interlock devices (IIDs) reduce rates of drinking and driving when installed on the vehicles of offenders. While the IID is installed on their vehicle, some drivers adapt their drinking behaviors, while others cannot. Heavy alcohol use and mental health concerns reduce treatment adherence in clinical settings, but it has not yet known how they pertain to behavioral adaptation to IIDs. OBJECTIVES: This study focuses on identifying driver typologies as predictors of performance while on alcohol IIDs. METHODS: The study utilizes the Managing Heavy Drinking study of drivers in New York state. Participants (N = 101; 59 males, 42 females) completed questionnaires assessing demographic information, drinking behaviors, driving history and mental health measures. All participants had been convicted of a DUI, and installed an IID. Latent class analysis was used to establish typologies and predict lockout ratios. RESULTS: Four typologies emerged and drivers with elevations in mental health concerns had significantly worse lockout ratios than those in other classes. CONCLUSIONS: The current study may provide support for interventions designed to identify drivers with comorbid mental health concerns and tailor appropriate interventions to administer while the IID is installed with the aim of improving behavioral adaptation to the device.

OBJECTIVE: Polydrug users have been shown to be at higher risk for alcohol consumption and crash involvement. However, research has shown that polydrug groups differ in some important ways. It is currently unknown how polydrug-using groups differ in terms of crash involvement and alcohol consumption. METHOD: The current study used latent class analysis to examine subgroups of polydrug users (n = 384) among a sample of drivers in Virginia Beach, Virginia (N = 10,512). A series of logistic regression analyses were conducted to determine the relationship between polydrug use categories and crash involvement and alcohol consumption. RESULTS: Four distinct subclasses of users were identified among polydrug-using drivers: Class 1 is the “marijuana-amphetamines class” and accounts for 21.6% of polydrug users. Class 2 is the “benzo-antidepressant class” and accounts for 39.0% of polydrug users. Class 3 is the “opioid-benzo class” and accounts for 32.7% of polydrug users. Finally, Class 4 is the “marijuana-cocaine class” and accounts for 6.7% of the study sample. Drivers in the opioid-benzo class were significantly more likely than those in any other class as well as non–drug users and single-drug users to be involved in a crash and were more likely than those in most other conditions to consume alcohol. No significant difference was found between marijuana-amphetamine users or benzo-antidepressant users and non–drug users on crash risk. CONCLUSIONS: Some polydrug users are indeed at greater risk for crash involvement and alcohol consumption; however, not all polydrug users are significantly worse than single-drug users and/or non–drug users, and the practice of lumping polydrug users together when predicting crash risk runs the risk of inaccurately attributing crash involvement to certain drivers.

Over the last two decades, many states have adopted several of the 20 laws that aim to control youth access to and possession of alcohol and prevent underage drinking in the United States. However, many of these laws have not been evaluated since their adoption. The objective of this study was to determine which minimum legal drinking age 21 (MLDA-21) laws currently have an effect on underage drinking-and-driving fatal crashes.We updated the effective dates of the 20 MLDA-21 laws examined in this study and used scores of each law's strengths and weaknesses. Our structural equation model included the 20 MLDA-21 laws, impaired driving laws, seat belt safety laws, economic strength, driving exposure, beer consumption, and fatal crash ratios of drinking-to-nondrinking drivers under age 21.Nine MLDA-21 laws were associated with significant decreases in fatal crash ratios of underage drinking drivers: possession of alcohol (-7.7%), purchase of alcohol (-4.2%), use alcohol and lose your license (-7.9%), zero tolerance .02 blood alcohol concentration limit for underage drivers (-2.9%), age of bartender ≥21 (-4.1%), state responsible beverage service program (-3.8%), fake identification support provisions for retailers (-11.9%), dram shop liability (-2.5%), and social host civil liability (-1.7%). Two laws were associated with significant increases in the fatal crash ratios of underage drinking drivers: prohibition of furnishing alcohol to minors (+7.2%) and registration of beer kegs (+9.6%).The nine effective MLDA-21 laws are estimated to be currently saving approximately 1,135 lives annually, yet only five states have enacted all nine laws. If all states adopted these nine effective MLDA-21 laws, it is estimated that an additional 210 lives could be saved every year.

Introduction There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization's business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patrons' perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club's bottom line. Method Data for this study were collected from entry and exit surveys with 1714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010–2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Results Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. Conclusions The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Practical Applications Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies.

We appreciate the three commentaries on our paper documenting the effectiveness of lowering the alcohol limit for driving from 0.08 to 0.05 blood alcohol concentration (BAC). Our purpose was to stimulate debate and, from the thoughtful commentaries received, we appear to have been successful. We thank Dr Sheehan [1] for her comments generally supporting the need for a 0.05 law in the United States, given that she is a researcher from a country that has had such a law in place in all Australian states since 1991. We also recognize the importance of the comments of Mr Talpins and Mr Hurley [2, 3], both strong safety advocates who have held senior positions with Mothers Against Drunk Driving (MADD). They both raised the typical argument expressed by opponents of the 0.05 law that the risk levels associated with BACs in the 0.05–0.07 range are modest. This is certainly true when 0.05 BAC is compared to risk levels at 0.15 and above. However, what is lost in this argument is that lowering the BAC limit for driving in the United States and abroad has typically affected these high BAC drivers just as much as drivers with low BACs [4-7]. This is one of the reasons that we are recommending the 0.05 BAC limit, because it has been proven to reduce the frequency of high BAC (>0.15) drivers in fatal crashes and serves as a general deterrent to drinking and driving. Lowering the BAC limit sends a message to the public that the law is becoming stricter and enforcement more intensive and, thus, reduces alcohol-related crash frequencies at all BAC levels. Mr Talpins also expresses concern that lowering the limit to 0.05 would substantially increase arrests and strain enforcement resources. However, there was no significant increase in driving while intoxicated (DWI) arrests when states lowered their limits from 0.10 to 0.08 in the 1990s and up to 2003 [8]. Lowering the BAC limit to 0.05 reduces the proportion of drivers on the roads who are impaired by alcohol, whether they are at 0.05, 0.08, 0.10 or 0.15 and greater [5, 6]. Mr Hurley notes that the lowering of the BAC limit from 0.10 to 0.08, in which MADD played a major role, saved 600–800 lives a year and argues that the effect of a 0.05 BAC law would be less. However, one study of the effects of the 0.08 BAC laws in the United States estimated that 0.08 BAC laws prevent 360 deaths per year and estimated that lowering the BAC limit even further to 0.05 would prevent an additional 538 deaths per year [5]. If the effects of lowering the limit from 0.08 to 0.05 in the United States are similar to those in Europe and Australia, we can expect a reduction of approximately 8% in impaired driving fatal crashes [9, 10], which would currently translate to 800–900 lives saved annually. We agree and support all four components of the MADD Campaign to Eliminate Drunk Driving; however, there is no evidence that high visibility enforcement has increased in the United States and no evidence that interlock laws have had a general deterrent effect on impaired driving. The advanced technology for passively detecting impaired drivers can certainly be set for a BAC of 0.05 or greater, and in numerous surveys [11] the public agrees with the statement that people should not drive after two or three drinks (less than 0.05 BAC for most people). Why not add one more evidence-based, proven countermeasure to the Campaign and support lowering the limit to 0.05? That policy will save lives as soon as it is adopted. 1. Sheehan M. A .05 BAC limit in the United States: an important challenge for policy, health and safety. Addiction 2014; 109: 875. 2. Talpins S. An argument for prioritizing drivers above the current illegal limit in the United States. Addiction 2014; 109: 875–877. 3. Hurley C. A better path to progress on drunk driving. Addiction 2014; 109: 877–878. 4. Hingson R., Heeren T., Winter M. Lowering state legal blood alcohol limits to 0.08 percent: the effect on fatal motor vehicle crashes. Am J Public Health 1996; 86: 1297–1299. 5. Wagenaar A., Maldonado-Molina M., Ma L., Tobler A., Komro K. Effects of legal BAC limits on fatal crash involvement: analyses of 28 states from 1976 through 2002. J Safety Res 2007; 38: 493–499. 6. Brooks C., Zaal D. Effects of a 0.05 Alcohol Limit in the Australian Capital Territory. Canberra, Australia: Federal Office of Road Safety MR 10; 1992. 7. Homel R. Drink-driving law enforcement and the legal blood alcohol limit in New South Wales. Accid Anal Prev 1994; 26: 147–155. 8. Federal Bureau of Investigation. Uniform Crime Reporting. Washington, DC: US Department of Justice, Federal Bureau of Investigation, Criminal Justice Information Services Division; 2012. 9. Henstridge J., Homel R., Mackay P. The long-term effects of random breath testing in Adelaide. In: Kloeden C. N., McLean A. J., editors. Proceedings of the 13th International Conference on Alcohol, Drugs and Traffic Safety—T′95, 13–18 August 1995. Adelaide, Australia: International Council on Alcohol, Drugs and Traffic Safety (ICADTS); 1995. 10. Smith D. I. Effect on traffic safety of introducing a 0.05% blood alcohol level in Queensland, Australia. Med Sci Law 1988; 28: 165–170. 11. Moulton B. E., Peterson A., Haddix D., Drew L. National Survey of Drinking and Driving Attitudes and Behaviors: 2008 (Volume II: Findings Report). Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration; 2010. Language: en

This article examines effects of the social group on individual alcohol and drug use upon entry and exit from the club. Based on collected biological measurements of alcohol and other drug use, this study explores whether social group indicators (e.g., group characteristics) are predictive of alcohol and other drug use for individual club patrons.A total of 368 social groups, representing 986 individuals (50.7% female), were anonymously surveyed, and biological measures of alcohol and other drug use were collected at entrance and exit to clubs on a single evening. Both individual and group-level indicators were assessed. Because data were clustered by club, event, and group, mixed-model regressions were conducted to account for non-independence.Group indicators of high blood alcohol concentration were being in a group that intends to get drunk, that has at least one member who regularly gets drunk, and that has discrepancies in its expectations regarding drug use. Group indicators related to cocaine use were high levels of drug use expected among group members, little discrepancy among the group members regarding the drug use expected, and high levels of intentions to get drunk. In addition, older groups were more likely to have higher levels of cocaine use. There were less consistent findings regarding group effects on marijuana use. The most consistent finding was that high drug use expectations were related to higher levels of marijuana use.Together, these data suggest that strategies should focus on recognizing group indicators as risks for group members. Promoting social responsibility for group members may create safer club experiences among young adults. These efforts could model designated-driver programs as a way to increase safety and social responsibility.

BACKGROUND: Interlocks reduce driving-under-the-influence (DUI) recidivism by 64%, but offenders resist installing them, preferring to risk driving while their driver's licenses are revoked. One method of motivating offenders to install an interlock is require it for reinstatement of their driver's license. This report updates an earlier evaluation of the administrative reinstatement interlock program (ARIP) procedure implemented in Florida in 2002. METHODS: Driver records and interlock program records covering 120,000 DUI offenders were followed over 10 years. The flow through the sanction system-conviction, reinstatement, interlock program, and postinterlock period-is described. Logistical regression was used to identify the characteristics of offenders who installed interlocks, and survival analysis was used to evaluate the recidivism of offenders in the various stages in the ARIP. RESULTS: At any given time, approximately one-third of the convicted offenders were serving their license-revocation periods. Half of the offenders who completed their revocation periods remain unqualified for reinstatement because they do not fulfill other requirements. ARIP offenders who do qualify for reinstatement and install interlocks have lower recidivism rates while the devices are on their vehicles. CONCLUSIONS: After 10 years, Florida's ARIP is a mature system that succeeds in forcing all offenders in the program who qualify for reinstatement to install an interlock for at least 6 months. However, half of all offenders who complete their mandatory revocation period are either unable to or choose not to qualify for reinstatement. Language: en

Background: This study used a pre- to post-design to evaluate the influence on drinking-and-driving fatal crashes of 6 laws directed at youth aged 20 and younger and 4 laws targeting all drivers. Methods: Data on the laws were drawn from the Alcohol Policy Information System data set (1998 to 2005), the Digests of State Alcohol Highway Safety Related Legislation (1983 to 2006), and the Westlaw database. The Fatality Analysis Reporting System data set (1982 to 2004) was used to assess the ratio of drinking to nondrinking drivers involved in fatal crashes [fatal crash incidence ratio (CIR)]. The data were analyzed using structural equation modeling techniques. Results: Significant decreases in the underage fatal CIR were associated with presence of 4 of the laws targeting youth (possession, purchase, use and lose, and zero tolerance) and 3 of the laws targeting all drivers (0.08 blood alcohol concentration illegal per se law, secondary or upgrade to a primary seat belt law, and an administrative license revocation law). Beer consumption was associated with a significant increase in the underage fatal CIR. The direct effects of laws targeting drivers of all ages on adult drinking drivers aged 26 and older were similar but of a smaller magnitude compared to the findings for those aged 20 and younger. It is estimated that the 2 core underage drinking laws (purchase and possession) and the zero tolerance law are currently saving an estimated 732 lives per year controlling for other exposure factors. If all states adopted use and lose laws, an additional 165 lives could be saved annually. Conclusions: These results provide substantial support for the effectiveness of under age 21 drinking laws with 4 of the 6 laws examined having significant associations with reductions in underage drinking-and-driving fatal crashes. These findings point to the importance of key underage drinking and traffic safety laws in efforts to reduce underage drinking-driver crashes. Language: en

Problem A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes. Method This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates. Results Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States. Discussion Laws and policies that may reduce the number of refusals are discussed. Impact on industry Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.

The initiation of teen driving, which occurs between ages 15 and 17, has generally been studied primarily in relation to crash injury reduction. However, it may be the most important period influencing development between puberty and emerging adulthood because, once the teens are driving on their own or riding with other teens, parental control over social behavior is greatly reduced and opportunities for risk-taking are substantially increased. The noncrash risks and benefits of licensing during this critical transition period are the subject of this paper.We identify "transition teens" as a subgroup of all 15-to 17-year-olds who reside in middle-class suburban and rural areas where families can afford a car and where a vehicle is needed for reasonable mobility. In this paper, we review recent studies on the effect of driving on non-traffic-related behaviors of teen drivers. Our analysis suggests that there are two environments that affect behavior and development: the home environment and the extended environment. Before driving age, the home environment influences are omnipresent in the life of the developing child. However, once teens can move more readily within the community and travel outside the home environment on their own or with a peer, they have access to locations where many or all the local controls on risky behavior may be absent.This article introduces the concept of "transitional teens" and provides a rough model that explains the possible risks encountered by this group when they begin to drive a vehicle or to ride with a peer. We offer this model to the research community with a challenge to hypothesize, test, and explore this proposed transitional period so that we can better understand and mitigate its associated risks.

Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users.Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events.Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.

Objectives. In 1999, New Zealand lowered the minimum purchasing age for alcohol from 20 to 18 years. We tested the hypothesis that this increased traffic crash injuries among 15- to 19-year-olds. Methods. Poisson regression was used to compute incidence rate ratios for the after to before incidence of alcohol-involved crashes and hospitalized injuries among 18- to 19-year-olds and 15- to 17-year-olds (20- to 24-year-olds were the reference). Results. Among young men, the ratio of the alcohol-involved crash rate after the law change to the period before was 12% larger (95% confidence interval [CI]=1.00, 1.25) for 18- to 19-year-olds and 14% larger (95% CI=1.01, 1.30) for 15- to 17-year-olds, relative to 20- to 24-year-olds. Among young women, the equivalent ratios were 51% larger (95% CI=1.17, 1.94) for 18- to 19-year-olds and 24% larger (95% CI=0.96, 1.59) for 15- to 17-year-olds. A similar pattern was observed for hospitalized injuries. Conclusions. Significantly more alcohol-involved crashes occurred among 15-to 19-year-olds than would have occurred had the purchase age not been reduced to 18 years. The effect size for 18- to 19-year-olds is remarkable given the legal exceptions to the pre-1999 law and its poor enforcement.

OBJECTIVES: From 1985 to 1995, drivers younger than 21 years experienced a 50% drop in fatal crashes involving alcohol. This study addresses whether the decrease is explained by young drivers' drinking less or by their separating drinking from driving. METHODS: Nighttime roadside surveys were conducted in 3 communities to test drivers' breath and administer questionnaires on drinking practices. From 1992 to 1996, 34,898 drivers (21% of whom were younger than 21 years) were interviewed. RESULTS: Although drivers younger than 21 years were more likely to have consumed 6 or more drinks on at least 1 occasion during the previous month, a smaller percentage of younger drivers than of older drivers had blood alcohol concentrations of 0.01 or higher. CONCLUSIONS: Younger drivers are more likely than drivers older than 21 years to separate drinking from driving.