Accuracy of alcohol diagnosis among DWI offenders referred for screening.
BACKGROUND
Most US courts use screening programs to evaluate substance-abuse problems of convicted driving while impaired (DWI) offenders. Typically self-report information determines need for treatment. However, little is known about the accuracy of self-reports of alcohol-use problems in this population.


METHODS
DSM-III-R alcohol abuse and dependence diagnoses from an initial, court-ordered screening evaluation of 583 female and 495 male convicted DWI offenders were compared with diagnoses and other self-reported information from a voluntary, noncoerced interview 5 years after the screening referral.


RESULTS
At initial screening, 16.8% of offenders were diagnosed with alcohol abuse and 20.1% with alcohol dependence. At the 5-year interview, 19.9 and 60.1% received a retrospective diagnosis of alcohol abuse or dependence at the age at which they were screened. Significantly fewer of those with a retrospective alcohol diagnosis reported that their alcohol use self-reports at screening were "very accurate" compared to those with no retrospective diagnosis.


CONCLUSIONS
Although many DWI offenders undergoing screening have diagnosable alcohol-related problems, underreporting is common, leading to inaccurate diagnosis and, therefore, a missed treatment opportunity. The research community and policymakers should review and reform the current screening system for alcohol-impaired drivers to better address this serious public health problem.
Lapham
Sandra C
SC
Behavioral Health Research Center of the Southwest, 612 Encino Place NE, Albuquerque, NM 87102, USA. slapham@bhrcs.org
C'de Baca
Janet
J
McMillan
Garnett
G
Hunt
William C
WC
D000293:Adolescent; D000328:Adult; D000435:Alcoholic Intoxication / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001334:Automobile Driving / Q000331:legislation & jurisprudence* / Q000523:psychology*; D015897:Comorbidity; D003937:Diagnosis, Differential; D000431:Ethanol / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000331:legislation & jurisprudence*; D001523:Mental Disorders / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D009516:New Mexico; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014342:Truth Disclosure
D000431:Ethanol