Addressing Alcohol-Impaired Driving: Training Physicians to Detect and Counsel Their Patients Who Drink Heavily

Rivara, F. P.; Dunn, C.; Simpson, E. · 2000 · ROSA P / United States. National Highway Traffic Safety Administration

archive: archived pipeline: cataloged verified

Get this paper ↗ (full text — opens at the source; we link to it, we don't host it)

Summary

This report evaluates a multi-faceted initiative funded by the National Highway Traffic Safety Administration to reduce alcohol-impaired driving by training physicians to detect and counsel patients with alcohol problems. The project was motivated by the high prevalence of alcoholism among trauma patients (25–40%) and primary care patients, which correlates with increased injury recurrence and drunk driving incidents. Despite evidence that brief interventions significantly reduce drinking and reinjury rates, routine screening and counseling were not common practices in medical settings due to physician pessimism regarding treatment efficacy and lack of training. The study, conducted in the Pacific Northwest (Washington, Alaska, Montana, and Idaho), employed several strategies to integrate alcohol screening and brief intervention protocols into medical education and practice. First, medical students at the University of Washington were trained through lectures and role-playing exercises during surgery and psychiatry clerkships, focusing on screening techniques and motivational interviewing. Second, residents received intensive skills training using case vignettes and standardized screening tools. Third, the project surveyed and revised the University of Washington School of Medicine curriculum to ensure consistent exposure to substance abuse topics across all four years of medical school, aligning with National Institute on Alcoholism and Alcohol Abuse guidelines. Finally, continuing medical education workshops were offered to approximately 1,200 practicing physicians in the region. Quantitative results from the resident training component demonstrated measurable improvements in clinical behavior and self-efficacy. Among 57 residents who provided data before and one month after training, the percentage of patients screened for alcohol problems increased from 27.2% to 38.1%. The rate of brief alcohol interventions provided rose from 6.3% to 9.9%. Furthermore, residents’ confidence in their ability to screen for alcohol problems increased from an average of 5.8 to 6.8 on a 10-point scale, and confidence in providing brief counseling rose from 4.9 to 6.0. Curriculum surveys revealed that while substance abuse content was present in various courses, it was often fragmented; the project recommended integrating comprehensive topics, such as epidemiology, screening, and brief intervention, into the core curriculum. The findings suggest that targeted training can effectively increase physician screening rates and confidence in managing alcohol-related issues. By embedding these skills into medical education and continuing education, the project aims to normalize brief interventions as a standard of care. The report concludes that disseminating these skills through medical schools and professional organizations is crucial for reducing alcohol-related injuries and impaired driving, given the significant proportion of the population that interacts with the healthcare system. The initiative also highlighted systemic barriers, such as insurance exclusions for alcohol-related injuries in many states, which may hinder widespread implementation.

Key finding

Resident screening rates for alcohol problems increased from 27% to 38% and confidence in screening and counseling abilities improved after receiving training in brief intervention techniques.

Methodology

mixed_methods

Sample size: 139

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via bulk_ingest_rosap on 2026-05-23 (6 acquisition events logged).

Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• dui enforcement