UK
Most alcohol dependent patients continue to drive in UK
By Psychiatric Bulletin
Mar 3, 2005, 18:12

The majority of patients diagnosed as alcohol dependent continue to drive, a new survey has found.

Published in the March issue of the Psychiatric Bulletin, the study surveyed patients to find out how much knowledge they had about the Driver and Vehicle Licensing Agency (DVLA) regulations.

Drivers have a duty to keep the DVLA informed of any condition that may impair their ability to drive. Doctors have a responsibility to advise their patients to inform the DVLA of any condition likely to make driving dangerous.

58 patients attending an alcohol problems clinic in Glasgow who had a diagnosis of alcohol dependence completed an anonymous questionnaire. All had a full UK driving licence, but two were currently banned from driving and were excluded from the survey.

Of the 56 patients studied, 89% had driven in the past year. 55% were driving daily, and only 11% were not driving at all.

For questions about the DVLA regulations, 57% either did not answer, or said that they did not know about them. Of those that did answer, 83% replied incorrectly.

90% of answers made reference to driving under the influence of alcohol, suggesting that at best many had only a limited understanding of the regulations.

Only 14% said that a health professional had discussed the DVLA regulations with them. Of those mentioned, four were general practitioners, one was a nurse and one a psychiatrist.

The final question in the survey asked: if doctors had a legal duty to inform the DVLA that you were continuing to drive contrary to their advice and this resulted in your licence being revoked for a year, would this affect your seeking treatment for your alcohol problem?

Of the patients who answered this question, 45% indicated that they would be less likely to seek treatment, or would not seek treatment at all. This finding has major implications for the doctor-patient relationship, say the researchers.

Indeed, the results of this study highlight several difficulties for health professionals managing patients with alcohol dependence who drive.

It appears that most heavy drinkers who possess a valid licence continue to drive, and nearly all are completely unaware that there are any restrictions for drivers with significant alcohol problems. As a result, it is hardly to be expected that these people will seek to inform the DVLA of their condition.

The authors of the study believe that the low level of patients stating that a health professional had informed them of the regulations is likely to reflect an avoidance on the part of professional to discuss such matters.

Once a patient reveals that he continues to drive and has not informed the DVLA, the onus is on the doctor to inform the agency. This can create bad feelings between doctor and patient, who is likely to see the professional's behaviour as intrusive or a breach of confidentiality.

Further useful research might involve a survey of health professionals about their knowledge of DVLA regulations and GMC advice, and their current attitudes and practice.

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