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• data from an Assessment of alcohol need amongst offenders within probation and prison services in North East England undertaken by the Institute of Health and Society, Newcastle University • the Alcohol Strategy Local Implementation Toolkit 24 developed by the Home Office to assist local areas to assess the needs of their populations, including those involved with the criminal justice system, and encourage PCTs to address any identified shortfalls in treatment capacity • the North West Public Health Observatory (NWPHO) 25 , which provides local health profiles incorporating data on crimes attributable to alcohol to assist PCTs, the NHS and their partners at a local level to understand their needs and develop planning Effectiveness and cost effectiveness In the prevailing economic climate, our focus has to be on improving provision based upon evidence of what is effective and, most importantly, cost-effective within budgetary constraints. There is evidence that a lot of the interventions NOMS delivers or refers offenders into are effective in reducing alcohol related harm to health, as set out in the Review of the effectiveness of treatment for alcohol problems or its more accessible summary. For example:- • The United Kingdom Alcohol Treatment Trial (UKATT) found that for every £1 spent on treating problem drinkers (social behaviour and network therapy and motivational enhancement therapy) £5 is saved on costs to health, social and criminal justice services 26 . This is likely to be an underestimate as it does not include loss of productivity or measure the full social costs of either alcohol related violence or the effects of alcohol problems on family and friends. • Brief interventions are effective in reducing alcohol consumption among hazardous and harmful drinkers to low-risk levels. • Cognitive behavioural approaches to specialist treatment offer the best chances of success. • People with more severe alcohol problems and levels of dependence should be encouraged to attend specialist treatment services. • Planned and structured aftercare is effective in improving outcomes following the initial treatment episode among those with more severe alcohol problems. 24 http://www.crimereduction.homeoffice.gov.uk/drugsalcohol/drugsalcohol097.htm 25 www.nwph.net/alcohol 26 http://www.bmj.com/cgi/content/full/331/7516/544 - 24 -
• Alcoholics Anonymous (AA) appears to be effective for those alcohol misusers who are suited to it and attend regularly and is a highly costeffective means of reducing alcohol related harm. More specifically, we can point to:- • Increasing ATR commencement and completion rates: � Commencements increased from 4708 in 2007 to 6545 in 2008 (a 39% rise) 27 � 3509 ATRs were completed in 2008/9 more than double the target (1635) introduced in the NOMS Performance Metrics 28 • The increasing capacity of the probation service e.g. through use of the Alcohol Information Pack to deliver more brief interventions in-house for the large numbers of offenders who have alcohol misuse and offending needs but don't require specialist treatment. We know from research that these are effective in reducing alcohol consumption among hazardous and harmful drinkers to low-risk levels 29 . • Recent research demonstrating that overall re-offending rates fall by almost 7% for offenders placed on substance misuse programmes (ASRO & OSAP) 30 . • A backdrop of increasing numbers of completions for all accredited behaviour programmes. The total number of completions in 2006-07 was 19,867, an increase of 18% compared with performance in the previous year 31 . As yet, little is known about the effectiveness of UK interventions/programmes in reducing alcohol-related crime. However, given the large number of offenders under statutory supervision who have an alcohol related criminogenic need 32 , reducing the alcohol consumption of this group to low risk levels through evidence based and appropriately targeted interventions should have a significant impact in reducing their likelihood of re-offending. 27 Offender Management Caseload Statistics 2008 http://www.justice.gov.uk/publications/prisonandprobation.htm 28 NOMS Annual Report and Accounts 2008/9 http://www.justice.gov.uk/publications/noms-annual-report-08-09.htm 29 Raistrick, D., Heather, N., and Godfrey C. (2006) Review of the Effectiveness of Treatment for Alcohol Problems. London: National Treatment Agency for Substance Misuse. 30 Hollis V. (2007) Reconviction Analysis of Programme Data using Interim Accredited Programmes Software (IAPS)) http://www.probation2000.com/ 31 NOMS ISAU Accredited Programme Delivery Annual Report 2006-7 32 A factor directly linked to their offending and potentially to their risk of reconviction. - 25 -
Page 1 and 2: NOMS Alcohol Interventions Guidance
Page 3 and 4: 122. Family issues 123. Safeguardin
Page 5 and 6: Glossary ATR Alcohol Treatment Requ
Page 7 and 8: NWPHO North West Public Health Obse
Page 9 and 10: The guidance was informed by: - •
Page 11 and 12: Models of care for alcohol misusers
Page 13 and 14: Drinking Categories Drinking Catego
Page 15 and 16: - Tier 3: Community-based, structur
Page 17 and 18: 3. CHANGE 4. CONTROL The primary pu
Page 19 and 20: • The Drink Impaired Drivers (DID
Page 21 and 22: Commissioning alcohol interventions
Page 23: • the contribution that can be ma
Page 27 and 28: interventions across the re-offendi
Page 29 and 30: Priorities highlighted by the JSNA
Page 31 and 32: set at Tier 3 within the above Oper
Page 33 and 34: Plotting a course through the commi
Page 35 and 36: to stand a better chance of success
Page 37 and 38: • Assessment of population needs
Page 39 and 40: Commissioning Framework for alcohol
Page 41 and 42: A suite of Key Performance Indicato
Page 43 and 44: Targeting This section of the guida
Page 45 and 46: Secondly, most offenders with alcoh
Page 47 and 48: small amounts of discretion to use
Page 49 and 50: have no other criminogenic need. DI
Page 51 and 52: Drinking Type Intervention MOCAM Ti
Page 53 and 54: or possibly dependant drinkers usin
Page 55 and 56: making risk of serious harm decisio
Page 57 and 58: The AUDIT score will generally be a
Page 59 and 60: Before engaging in structured treat
Page 61 and 62: Court proposals and the sentencing
Page 63 and 64: • arrangements have been or can b
Page 65 and 66: Supervision requirement Seriousness
Page 67 and 68: Alcohol Specified Activity Requirem
Page 69 and 70: oral report assessment or FDR pack.
Page 71 and 72: Where high intensity orders are pro
Page 73 and 74: Delivery of interventions The amoun
Page 75 and 76:
women reducing their drinking level
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of brief interventions; the types o
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• Look at the offender’s person
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Providers are then better able to f
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Independent research suggests that
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• structured day and care planned
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fortnight. Home detoxifications are
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2d.10.2 The offender is instructed
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Information sharing protocols Areas
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The first meeting with the offender
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which consists simply of the first
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DID should only run alongside an AT
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has developed a nationally approved
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Managing the sentence Alcohol misus
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or 2. Set weekly sessions for 12 we
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esponse to such an application, the
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• Anyone who has received treatme
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Areas/trusts should have in place a
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Women may be more reluctant to admi
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Sanctions are greater for women wit
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Information Pack for Offenders 125
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• Young people have an experiment
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There is some research evidence tha
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and dual diagnosis. Guidance for pr
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in Reduction 161 , for prisons in 2
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lead to changes in substance use an
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inter-agency training day where pro
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Guidelines Council (SGC) advice tha
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Testing Legal position Unlike the d
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where alcohol is a known disinhibit
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Also - National Standards for Offen
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Improving continuity of care The im
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2. Sentences of 12 months or more:
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to compel offenders to submit to dr
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Post-release provision Areas/trusts
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during the development of local str
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substitute arrangements might be pu
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Working in partnership Effective lo
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� Clear lead agency on each case
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Training and development Offender M
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Social Care and Community Justice.
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Performance management Why do we co
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A successful completion of an ATR i
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Specialist alcohol staff should be
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References Addaction (2009) Closing
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Department of Health/NHS Finance Pe
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McSweeney, T., Webster, R., Turnbul
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Raistrick, D., Heather, N., and God
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PC 57/2005 Effective management of
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ASSESSMENT OF NEED Very harmful/Dep
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North East Region To commission an
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Gloucester shire Leicestershire & R
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2009-10 Probation Area/Trust Glouce
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West Yorkshire To ensure that probl
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