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Brief Interventions and Criminal Justice

Alcohol and drug use is closely linked to crime.

According to the 2002 National Crime Victimization Survey, 21.6 percent of victims of violent crimes thought or knew the offender had consumed alcohol. Approximately 40 percent of offenders on probation reported that they had been using alcohol at the time of their offense. In 2001, 1.4 million driving-while-impaired (DWI3) arrests were made, making this the number one crime related to alcohol and other drug (AOD) use other than drug possession. (3 “DWI,” or driving while impaired, is used generically to refer to the impaired driving offense and includes impairment by alcohol and/or other drugs.)

Few studies have evaluated the impact of brief interventions in criminal justice populations. Davis and colleagues examined whether brief motivational feedback helped to increase offenders’ participation in treatment after they completed their jail sentences. They found that offenders receiving feedback were more likely to schedule and keep appointments for followup treatment than were offenders in a control

Many clinicians consider situations in which a patient receives acute medical care for an alcohol-related injury to be “teachable moments” – situations in which the patient may be particularly open to an alcohol intervention. Brief interventions delivered while patients are receiving trauma care may reduce those patients’ alcohol consumption and risk of subsequent alcohol-related injuries.

Few studies have evaluated the impact of brief interventions in criminal justice populations. Davis and colleagues  examined whether brief motivational feedback helped to increase offenders’ participation in treatment after they completed their jail sentences. They found that offenders receiving feedback were more likely to schedule and keep appointments for follow up treatment than were offenders in a control group. However, a study of DWI offenders found that brief individual interventions reduced recidivism only among offenders who showed evidence of depression, but not among offenders who were not depressed.

This study suggests that brief interventions may be particularly useful in certain subgroups of DWI offenders. More research is needed to evaluate the effectiveness of brief interventions within the criminal justice system, especially considering the large number of people arrested each year for AOD-related offenses and the high recidivism rates among them.

The Important Conclusion

Brief interventions can be useful in a variety of settings and are potentially cost-effective in reducing hazardous or harmful alcohol consumption. Medical settings such as emergency departments or trauma centers also may provide opportunities, or “teachable moments,” when people may be open to making changes in their alcohol consumption. New technology, such as computerized interventions, may offer an effective means for implementing brief interventions, especially in settings in which time constraints or lack of resources or training in intervention techniques are issues.

Research is yielding new information on the efficacy of various brief interventions at a rapid pace; practitioners, clinicians, college administrators, and others responsible for initiating screening and brief interventions should consider this new scientific evidence when deciding which strategies best fit their situations.

REFERENCES

(1) Moyer, A., and Finney, J.W. Brief interventions for alcohol problems: Factors that facilitate implementation. Alcohol Research & Health 28(1):44-50, 2004/2005. (2) Moyer, A.; Finney, J.W.; Swearingen, C.E.; and Vergun, P. Brief interventions for alcohol problems: A meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction 97:279-292, 2002. (3) Miller, W.R., and Rollnick, S. Motivational Interviewing: Preparing People for Change. New York: Guilford Press, 2002. (4) Butler, S.F.; Chiauzzi, E.; Bromberg, J.I.; et al. Computer-assisted screening and intervention for alcohol problems in primary care. Journal of Technology in Human Services 21:1-19, 2003. (5) Squires, D.D., and Hester, R.K. Using technological innovations in clinical practice: The Drinker’s Check-Up Software Program. Journal of Clinical Psychology 60:159-169, 2004. (6) Gerbert, B.; Berg-Smith, S.; Mancuso, M.; et al. Using innovative video doctor technology in primary care to deliver brief smoking and alcohol intervention. Health Promotion and Practice 4:249-261, 2003. (7) Whitlock, E.P.; Polen, M.R.; Green, C.A.; et al. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 140:557-568, 2004. (8) U.S. Preventive Services Task Force (USPSTF). Screening for hepatitis C virus infection in adults: Recommendation statement. Annals of Internal Medicine 140:462^164, 2004. (9) Cuijpers, P.; Riper, H.; and Lemmers, L. The effects on mortality of brief interventions for problem drinking: A meta-analysis. Addiction 99:839-845, 2004. (10) Fleming, M.F.; Manwell, L.B.; Barry, K.L.; and Johnson, K. At-risk drinking in an HMO primary care sample: Prevalence and health policy implications. American Journal of Public Health 88:90-93, 1998. (11) Fleming, M.F.