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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
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_______________________________ ↓ Not charged 40% of all cases pled or found guilty From arrest to conviction: final outcome of cases _____________________________________________ ↓ 49% of all cases do not get to court ↑ 40% of all cases convicted _____________________________________________ 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.
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Research undertaken to inform the Alcohol Pathway of the prevalence of alcohol misuse amongst offenders in the North East of England.
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Subjects Three probation areas: –Northumbria –Durham –Teesside (not all offices in each area) Four prisons: –Durham –Deerbolt –Holme House –Low Newton
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All offenders for the month of November 2006 were asked to complete a questionnaire 715 completed from a possible 1131 cases (63%)
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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]
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Alcohol prevalence 15% reported that they did not drink (8% women).
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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)
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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)
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However… when comparing AUDIT scores to OASYs alcohol scores Audit Range% missed using OASys Abstainers-5% Low Risk-12% Hazardous Risk73% Harmful Risk46% Possibly Dependence14%
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What’s happening?
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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
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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)
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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
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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
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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)
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£5 saved to CJS (UK alcohol treatment trial) For every £1 spent on alcohol treatment What we do know…..
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