A prevalence study of alcohol amongst offenders in

A prevalence study of alcohol amongst offenders in the probation and prison services in North East England Dr. Dorothy Newbury-Birch Senior Research Associate dorothy. newbury-birch@ncl. ac. uk

From arrest to conviction: final outcome of cases 40% of all↑ 40% of all cases convicted cases pled or found guilty ______________________________________ ↓ 49% ↓ Notcases do not of all charged get to court From: Entry into the criminal justice system: a survey of police arrests and their outcomes. (1998) Phillips C and Brown D. Home Office Research Study 185.

• Research undertaken to inform the Alcohol Pathway of the prevalence of alcohol misuse amongst offenders in the North East of England.

Subjects • Three probation areas: – Northumbria – Durham – Teesside (not all offices in each area) • Four prisons: – – Durham Deerbolt Holme House Low Newton

• All offenders for the month of November 2006 were asked to complete a questionnaire • 715 completed from a possible 1131 cases (63%)

Results - Age • 94% of prison cases and 86% of probation cases were men • Half of those who answered were aged between 22 -34 [probation 49%, prison 51%] • 25% were aged between 18 -21 [27% probation, 24% prison] • 22% were aged between 35 -49 [21% probation, 23% prison] • 2% were aged 50 or more [3% probation, 2% prison]

Alcohol prevalence • 15% reported that they did not drink (8% women).

Alcohol prevalence • In the probation setting 69% of men and 53% of women were classed as having an AUD • In the prison setting 59% of men and 63% of women were classed as having an AUD • This is compared to 38% of men and 16% of women in the general population (ANARP 2004)

Alcohol prevalence • In the probation setting 35% of men and 25% of women were classed as ‘possibly dependant’ • In the prison setting 36% of men and 42% of women were classed as ‘possibly dependant’ • This is compared to 6% of men and 2% of women in the general population (ANARP 2004)

However… when comparing AUDIT scores to OASYs alcohol scores Audit Range Abstainers Low Risk Hazardous Risk Harmful Risk Possibly Dependence % missed using OASys -5% -12% 73% 46% 14%

What’s happening?

• Primary Aim - Address evidence gaps associated with SBIs for Alcohol Misuse • Funded by DH; £ 3. 2 million as an action under the “Alcohol Harm Reduction Strategy for England” (2004) • Collaboration between: – Institute of Psychiatry, London – Newcastle University, Institute of Health and Society – University of York

Primary Aims of SIPS To identify: 1. The best screening methods 2. The most effective intervention techniques 3. The most appropriate, acceptable and cost effective methods of implementation for detecting harmful & hazardous alcohol consumption across 3 health and social care settings: - Primary Health Care (PHC) - Accident & Emergency Departments (AED) - Probation (CJS)

Design Methodology • Pragmatic Cluster RCTs • • North East, London, South East 2 year time span (6 & 12 month follow-up) • Intervention Approaches • Patient Information Leaflet (PIL) • Brief advice 5 minutes + PIL • Extended intervention 20 -30 minutes + PIL • Screening Tools • AUDIT: gold standard • FAST: 4 questions • M- SASQ: 1 question • M-PAT: AED related

Research Programme Design • For the whole trial participants will be recruited from: – 24 PHC practices – 31 patients from each – 9 AEDs – 131 patients from each – 96 Offender Managers in Probation – 5 clients from each • North East will work with 12 GP practices, 4 AEDs and 43 Offender Managers • The overall aim is to recruit over 2, 600 people across the three trials

Outcome Measures – Implementation: barriers and facilitators – Identify most effective screening tools – Assess effects on drinking patterns – Explore most cost effective intervention approach – Common measures and design to allow comparisons – Best methods to roll-out nationally (e. g. need for AHWs)

What we do know…. . For every £ 1 spent on alcohol treatment £ 5 saved to CJS (UK alcohol treatment trial)