Alcohol Misuse: Criminal Justice

Contexts & Outcomes

National Infrastructure for Translating Research into Clinical PracticeNIH-NIAAA 1R25AA02048001

Arlington, VA 9/17/14

Randall Brown MD, PhD, FASAMProgram Director

University of Wisconsin

Summary of Module Contents

• Slide Deck: N = 40• Handout materials: slides, article

reprints• Annotated bibliography• Test questions: 5 pretest; 5 posttest• Suggestions & resources– Natl Center for DWI Courts• Treatment court attendance (NCDC)• Advisory panel involvement

– Formulation of driver safety plans

Overview• Alcohol misuse violence and

trauma• Penalty w/o treatment previous

drinking patterns + associated behavior

• 40% Tx referrals originate in criminal justice

Overview

• Key Point– Collaborative, multi-pronged interventions

improve outcomes

• Main recommendations– Screen & intervene to prevent alcohol-

related crime & trauma– Collaborate w/ supervision– Address co-morbidity

Key Point Overview

• Collaborative, multi-faceted intervention– Treatment + supervision– Holistic approach• Comorbidity• Social circumstances• Engagement of close personal contacts• “Behavioral” & relational issues

– Monitoring/accountability

Recommendation #1

• Screen & intervene to prevent future alcohol-related issues

• SORT level B• References– D’Onofrio G et al. Ann Emerg Med, 2012; 60: 181-

92.– Field C et al. ACER, 2010; 34: 2004-10.– Schermer C et al. J Trauma, 2006; 60: 29-34.

Recommendation #2

• Collaborate with supervision• SORT B• References– Friedmann P et al. Addiction, 2012; 107: 1099-

1108.– Guydish J et al. Crime Delinq, 201; 211: 167-98.

Dissemination Strategy

• Module for formal didactic (1 hour)• Interfacing with criminal justice– Treatment court (OWI, veteran)– Involvement in safe driver plans– Deferred prosecution unit

• Systems process improvement– FQHC– VA– Court/corrections advisory role