DUI: A Sign of Addiction?If you have ever been arrested for driving under the influence (DUI), or in some jurisdictions driving while intoxicated (DWI), you quickly learned the legal and financial consequences of driving while impaired, but you may have been left wondering what the DUI means for your personal well-being. Did you make a one-time mistake, or could a DUI be a sign of a bigger problem?

The question, to a degree, will be decided for you. Currently, 45 states and the District of Columbia require alcohol evaluation and treatment after the first DUI. In many states, education includes classes on the dangers of driving while impaired, with more classes added if the evaluation determines that the driver has a drinking problem.

For second or subsequent DWI offenders, most states will not only require alcohol assessment and treatment, but will impose a one-year license suspension, impound or immobilize the vehicle, and sentence the offender to jail or 30 days of community service.

ifidrinkHow much alcohol can you drink before you exceed the legal limit, putting yourself and others in danger? It is common for people to underestimate alcohol’s impact on their balance, speed, accuracy and reaction time behind the wheel, yet research shows that serious negative effects can result after as little as one or two drinks. “If I Drink…” helps people understand, in a visual, easy-to-understand way, just how severely alcohol affects their ability to drive safely. It provides a first-person virtual experience of riding a bike, driving a car or walking the line at different BAC levels, ranging from sober to extremely intoxicated. Try it here.

More Than a Simple Choice

If you have ever had to navigate your way through the justice system after a DUI, you may have noticed that you had plenty of company. According to the Centers for Disease Control and Prevention, more than 1.4 millionpeople were arrested for driving under the influence of alcohol or narcotics in 2010. And the number of impaired drivers on the road may actually be much higher; according to the AAA Foundation for Traffic Safety, one in 10 drivers report they may have driven while legally intoxicated one or more times in the past year. (Nationwide, non-commercial drivers are considered to be impaired when their blood alcohol concentration (BAC) reaches .08 grams per deciliter, commonly expressed as .08 percent.)

Although most drivers will adjust their drinking and driving behavior after a DUI, a portion will not. In fact, 33 percent of DUI citations go to repeat offenders, according to a report by the National Highway Traffic Safety Administration. While not proof of addiction, this can be a red flag. Continuing to drink or use in spite of negative consequences, such as DUI or other legal problems, is one of the telltale signs of addiction.

In many cases, those who drink and drive are struggling with more than just a behavioral choice or physical craving. Increasingly, researchers are finding that the decision to drink and drive is an exceedingly complex issue with physiological underpinnings. In a study of 34 repeat DUI offenders involved in alcohol-related crashes, researchers found that repeat offenders may have subtle deficits in their decision-making abilities that make it hard for them to recognize cause and effect.

The recidivists did not suffer from poor impulse control in the here and now, the researchers concluded, but they struggled to connect the dots  between drinking and citations. In short, when it comes to drinking and driving, some may be wired to make poor decisions.

Adding to the body of evidence that brain chemistry plays a role in drinking and driving, in a study of DUI recipients with two or more citations, researchers at the Pacific Institute for Research and Evaluation in New Mexico found that more than half reported having suffered from, or were currently suffering from, at least one mental illness, including major depression, bipolar disorder, obsessive-compulsive disorder or posttraumatic stress disorder.

Other findings by the same principal investigator suggest that even one DUI can spell trouble. In a study of nearly 700 DUI recipients, 19 percent reported a lifetime of heavy drinking, and almost half said they had been struggling with heavy drinking for many years. Another 25 percent had resumed heavy drinking one or more interludes of moderate drinking or abstinence.

If there is a silver lining to getting a DUI, it’s that consequences are sometimes enough to help people recognize they have a problem and get treatment. We know that addiction is a chronic, progressive disease. We also know that slapping the drunk driver with fines or suspended licenses or even jail time does not get to the root of the problem. Without treatment of the underlying issues, people struggling with alcohol dependence will not have the tools to quit for good (and hence avoid re-offending).

Driven to Change

Even for the light social drinker, the DUI can be a wake-up call. It is a reminder that even a small amount of alcohol doesn’t mix with driving. Take a look at the “If I Drink” app to experience sober what drinking does to your ability to drive, bike and walk a straight line. Keep in mind that an average adult can process about one drink an hour (a 12-ounce beer, five-ounces of wine, or a shot of hard liquor). But even following that rule of thumb doesn’t guarantee you won’t get a DUI. Factors such as weight, gender (a woman will have a higher BAC than a man of the same weight), and the type and amount of food in your stomach can all influence your BAC.

Getting a DUI can be  traumatic, and it should be. Drinking too much then getting behind the wheel is never OK and puts lives at risk. But a DUI can also be a blessing in disguise. Since it’s a clear consequence imposed by an unbiased third party, it can be a wake-up call for the recipient or present an opportunity for loved ones to break through an addict’s denial about a drug or alcohol problem. If you have a problem with alcohol or drugs, getting a DUI can trigger the first step toward getting sober.

 

David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment centers that includes Promises Treatment Centers in California, The Ranch outside Nashville, The Recovery Place in Florida, and Right Step.