Alcohol screening and brief intervention in criminal justice settings: the UK SIPS trials

Purpose: The annual cost of alcohol related harm in the UK is estimated to be between £17.7

and £25.1 billion with the costs of alcohol fuelled crime and disorder accounting for £7.3 billion

each year. Although there have been many trials of screening and brief alcohol intervention in

primary care and most have reported positive effects of brief intervention, in terms of reduced

alcohol consumption in excessive drinkers there is a lack of evidence within the criminal justice

arena. The SIPS trial aimed to evaluate the effectiveness and cost-effectiveness of different

models of screening to identify hazardous and harmful drinkers and different intensities of brief

intervention to reduce excessive drinking in routine criminal justice services (probation).

Methods: Offender Managers across the North East, London and South East of England

were recruited. Offender Managers were randomly allocated to one of three intervention

conditions: (i) a leaflet-only control group; (ii) brief structured advice and (iii) brief lifestyle

counseling. Each Offender Manager was asked to recruit at least 5 hazardous or harmful

drinkers who received a short baseline assessment followed by brief intervention. Offender

Managers were also randomized to use either the FAST or M-SASQ alcohol screening tools.

Results: Initial results indicate a high prevalence of alcohol use disorders in this population

(68%). A total of 976 offenders were approached. Of these 854 were eligible and were screened

with 573 screening positive. The main reasons for ineligibility were that offenders were currently

seeking help for alcohol use (51%) and mental health issues (24%). The mean age of those

randomized was 31.4 (CI 30.7–32.2); 85% were male and 67% classified their ethnicity as

White. Nearly three quarters were current smokers (74%) and just under half carried on their

education after the age of 16 (46%) and 16% indicated that they were educated to degree level.

Discussion: The presentation will examine the characteristics of patients identified by each

screening strategy and the relative efficiency of the screening tools in the criminal justice

system.