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ALCOHOLISM, MENTAL ILLNESS AND THE "DRUNK DRIVER"
MELVIN L. SELZER; CHARLES E. PAYNE; JEAN D. GIFFORD; WILLIAM L. KELLY
Am J Psychiatry 1963;120:326-331.
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Dept. of Psychiatry, University of Michigan Medical Center, Ann Arbor, Mich.

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Abstract

A series of 67 drivers arrested for driving in an intoxicated state were examined to determine the incidence of alcoholism and psychic illness: 38 (57%) drivers were alcoholic, 10 (15%) were classified as "probably alcoholic," 4 were pre-alcoholic and 15 were not alcoholic. If the alcoholics, probable alcoholics and pre-alcoholics are considered together, no less than 78% of the arrested drivers had pathological drinking problems.At least 45 drivers (67%) suffered from recognizable psychiatric illness exclusive of alcoholism. Of the 52 pathological drinkers, 40 had classifiable psychiatric illness in addition to their drinking problem; 33 were personality disorders (29 passive-aggressive personalities, 2 sociopaths, 1 unstable personality, 1 paranoid personality), 4 were depressed and 3 schizophrenic. Of the 15 non-alcoholic drivers, 5 had personality disorders; 4 passive-aggressive personalities, and 1 sociopath.The entire group was heavily weighted toward the bottom of the socio-economic scale with 80% in Hollingshead's classes IV and V.Snce it is often postulated that alcoholinvolved accidents can be reduced by educating party-givers to modify their driving guests intake, the drinking site was elicited. Twenty-seven drivers did their prior drinking in taverns, 8 in private clubs, 10 at house parties, 6 at the home of friends, 4 in their automobiles and only 8 in their own homes. Contrary to popular belief, most alcoholics avoid solitary drinking and will weave their intoxicated way long distances to enjoy drinking companionship.This study lends support to the concept that the larger body of drinking drivers is distinct from the so-called "drunk drivers" who are responsible for a substantial number of serious traffic accidents and violations. It appears that many alcohol-involved traffic mishaps and violations are incurred by alcoholic persons whose abnormality immunizes them against the usual educacational appeals and legal devices intended to curb intoxicated driving. Detection of the alcoholic driver's addiction followed by rehabilitative efforts will help protect the community from repeated exposure to automotive depredations at the hands of the same accident-susceptible individuals. Alcoholic drivers convicted of alcohol-caused traffic offenses should be required to undergo treatment prior to resuming driving.

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