酒駕累犯「酒癮者」的敘事分析

A Narrative Analysis of Drunk Driving Recidivism among Alcoholics

在媒體熱衷於採訪事故現場和帶有情緒的播報渲染下，酒駕者被型塑成殘忍與萬惡不赦，社會輿論亦對酒駕行為感到憤怒。同時，酒駕累犯者也可能在檢察官要求接受精神醫療評估下，成為「酒癮者」。然而，酒駕累犯「酒癮者」對於自身被診斷具酒癮且需進行治療而感到委屈。明顯的，酒癮者在台灣司法與精神醫療體制去脈絡化和個人歸因的理解方式下，其聲音在現行體制是不被聽見的。因此，本研究從酒駕累犯「酒癮者」自身觀點出發，依其生命歷程來理解其使用酒精之路和對自身酒癮，及緩起訴附命戒癮治療之看法，期待對實務工作者如何與酒駕累犯「酒癮者」一同工作提供建議。
本研究採取敘事分析法（narrative analysis），針對五位酒駕累犯「酒癮者」深度訪談，蒐集其個人飲酒的生命故事，並輔病歷紀錄、地檢署轉介單等進行分析。研究發現有四：1.酒駕累犯「酒癮者」在青少年時期，因著人際互動、工作需要和社會風氣，開始飲酒且逐漸過量；2.酒駕除了是因自認能控制飲酒量、心存僥倖等個人因素外，喝酒同伴均酒駕的從眾效應亦產生影響；3.相較於門診治療，團體心理治療較能讓他們彼此互相分享與同理，促使減/戒酒意願；4.酒駕累犯「酒癮者」否認酒癮的標籤與接受治療的必要性，並認為緩起訴以戒癮為目標不切實際，反而應是少喝和不酒駕。
研究建議有三：1.酒駕罰則應針對個人與情境進行調整，而非僅期待一致性的罰則即能遏止酒駕；2.緩起訴附命戒癮治療應審視酒駕累犯「酒癮者」實際需求，提供支持與陪伴，並多開辦團體心理治療，增進戒癮動機與預防酒駕再犯；3.精神醫療社會工作者，應審視自身對於酒駕累犯「酒癮者」態度和處遇視角，考量其生命經驗與社會脈絡，進行全方面評估與處遇。

Drunk driving recidivism is frequently described as cruel and unpardonably vicious particularly while the media are keen on interviewing victims at the accident scene and announcing with emotional dramatic exaggeration and contagion; hence, the public is angry about drunk driving. Meanwhile, drunk driving recidivism should require prosecutors to carry out mental status examination that defines offenders as“alcoholics”. However, drunk driving recidivism among alcoholics occurs where they subsequently feel wronged by their actual diagnosis with alcohol use disorder. Apparently, under the decontextualization and personal attribution of the judicial and psychiatric systems, the voice of drunk driving recidivism among alcoholics is not heard in the current situation. Accordingly, this research investigates drunk driving recidivism from the point of view of alcoholics, and bases evidence from their life course to enable them to self-actualize their path to alcohol use, while viewing their own addiction to alcohol and subsequent treatment via deferred prosecution. The authors anticipate providing suggestions for practitioners in working in this field of drunk driving recidivism among alcoholics.
This research adopts narrative analysis, conducts in-depth interviews with five drunk driving recidivism cases among alcoholics to collect their life stories of personal drinking, and then analyzes their medical records and referral forms from the office of the district prosecutors. Four key takeaways were discovered: 1) drunk driving recidivism among alcoholics arises from starting to drink for interpersonal interaction, work needs and the social climate in adolescence; 2) in their opinion, in addition to controlling their drinking capacity in risk-taking (for driving a vehicle mainly), the bandwagon (social desirability response set) effect of drinking and driving among drinking companions also produces impact; 3) compared with outpatient treatment, group psychotherapy can better allow them to share and empathize with each other and promote their reduction/quitting drinking; and 4) drunk driving recidivism among alcoholics tend to deny the stigma of alcohol addiction and the necessity of treatment. In their opinion, deferred prosecution that aims toward quitting drinking behaviors is unrealistic; instead, drinking less and not driving when driving is more realistic.
This research suggests three points: 1) drunk driving policies should be adjusted to the individual and the situation, rather than excepting consistent punishment can discipline the drunk driver; 2) addiction treatment via deferred prosecution should examine the actual requirement of drunk driving recidivism among alcoholics through providing support and companionship through group psychotherapy to increase motivation for addiction recovery and prevent drunk driving recidivism; and finally 3) psychiatric social workers should examine their own attitudes, expectations and perspective of treatment in consideration of the offenders’life experience and social context, thereby conducting comprehensive and appropriate assessment and interventional treatment.