Background: Driving under the influence has been an overlooked consequence of the opioid epidemic. Although recent reports have highlighted the increased prevalence of DUI in rural communities and the extensive mental health problems and criminal and drug use histories among rural Appalachian DUI offenders, it is unclear how Appalachian DUI populations compare to DUI offenders in other regions.
Purpose: To help fill this void in the literature, the current study uses a statewide sample to examine how Appalachian DUI offenders differ from non-Appalachian DUI offenders in a predominantly rural state.
Methods: Assessment records were examined for 11,640 Kentucky DUI offenders who completed an intervention in 2017. Appalachian DUI offenders were compared to non-Appalachian metro and nonmetro DUI offenders. Demographic information, DUI violation details, DSM-5 substance-use disorder criteria, and referral information were compared using ANCOVAs and logistic regression models.
Results: More than one fourth of the sample were convicted in an Appalachian county. Compared to non-Appalachian DUI offenders, Appalachian offenders were significantly older and more likely to have a prior DUI conviction, to meet DSM-5 criteria for a drug-use disorder, and to drive while drug-impaired. Referral and intervention compliance also varied across groups.
Implications: Results suggest that Appalachian DUI offenders are more drug-involved and have increased risk of recidivism. Findings indicate a need for practitioners to consider the distinct needs of Appalachian DUI offenders during service delivery. Future research should explore alternative intervention methods for preventing continued impaired driving in Appalachia given limited treatment availability in the region
