Predictors of impaired driving among injured emergency department patients who report risky drinking

Background/Purpose: Impaired driving is a major public health concern; in 2010 over 10,000 people died in alcohol-impaired driving crashes, and many more were injured. This analysis seeks to determine screening questions that could identify injured patients with risky alcohol use presenting to the emergency department (ED) who might benefit from counseling regarding impaired driving. Methods: This cross-sectional study, which is nested within a larger randomized controlled trial, enrolled injured ED patients who screened positive for risky alcohol use based on the WHO's ASSIST. This analysis focuses on the first 684 participants enrolled from July 2010 through December 2012. Results/Outcomes: A total of 514 (75.2%) participants reported driving within the past 12 months. Of those, 143 (27.8%) reported driving after having “too much to drink” in the past 30 days. In the multivariable model, gender (odds ratio (OR) [95% confidence interval (CI)] 0.56 [0.36, 0.87] for females as compared to males), exceeding NIAAA drinking guidelines for weekly alcohol use (1.92 [1.26, 2.92]), or for binge alcohol use (3.38 [1.47, 7.76]), and having been in a motor vehicle crash (MVC) in the past 12 months (2.04 [1.34, 3.01]) remained significant predictors of impaired driving. Conclusions: Asking patients if they consume more than 7 (women) or 14 (men) drinks per week, if they consume more than 3 (women) or 4 (men) drinks on a single occasion, and if they have been in an MVC in the past year could identify those patients who may benefit from counseling regarding impaired driving.