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Since a high percentage of offenders convicted of driving while impaired (DWI) suffer from alcohol abuse or dependence, many courts require DWI offenders to undergo assessments of their drinking. These screenings, however, are often inaccurate due to under-reporting. Offenders under-report their alcohol use out of concern for legal and social consequences. They may be ashamed and thus defensive about their alcohol use. And, offenders must pay for the screening and subsequent treatment so they falsify information to avoid the costs.

To identify the extent of this under-reporting, researchers compared the diagnoses of alcohol abuse or dependence of DWI offenders during earlier court-ordered screening with diagnoses from self-reported information five years later during a voluntary second interview. In the second interview, 583 women and 495 men were asked to provide information concerning current alcohol use. They were also asked to recall their experience five years earlier during the initial screening and diagnosis and were asked how accurately they reported their alcohol use at that time.

During the initial screening, 16.8% of offenders were diagnosed with alcohol abuse and 20.1% with dependence. Five years later, the diagnoses for these offenders increased significantly: 19.9% were diagnosed with alcohol abuse and 60.1% with dependence. In other words, over half (59%) of the offenders received a less severe diagnosis at the initial screening than at the 5-year second interview. The rate of under-reporting alcohol use in the initial screening was greatest among non-Hispanic whites (62.4%). Native Americans were least likely (46.1%) to underreport their alcohol use. Surprisingly, 61.1% of the offenders who were diagnosed as alcohol-dependent during the second interview responded that they “very accurately” reported their alcohol use during the initial screening.

Researchers concluded that, despite a comprehensive and rigorous screening program, 59% of offenders underreported alcohol abuse or dependence. Under-reporting leads to inaccurate diagnoses and missed treatment opportunities. The researchers suggest longer screening interviews and motivational approaches to encourage more accurate reporting and provide screeners with easy access to driving and criminal records. A more radical approach would be to eliminate screening and require universal treatment, during which there would be more time to evaluate and diagnose offenders. However, some providers feel that universal treatment for all offenders is neither in the offenders’ nor the public’s best interests.

(Lapham, SC, C’de Gaca, J, McMillan, G, and Hunt, WC: Accuracy of alcohol diagnosis among DWI offenders referred for screening. Drug and Alcohol Dependence 76: 135–141, 2004.)

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