Computer-assisted screening, brief intervention and referral to treatment for dwi offenders

Driving while intoxicated (DWI) is a common, reoccurring, and costly crime.  In fact, DWI is one of the most frequently committed crimes in the United States and approximately one third of those arrested are likely to re-offend.  This is a major issue in terms of both public safety and monetary costs.  One reason for high rates of recidivism is that a significant proportion of those with a DWI have an alcohol use disorder.  Despite the prevalence of alcohol use disorder and its implications for DWI recidivism, most DWI offenders remain untreated during their contact with the criminal justice system.  Typically, court ordered treatment occurs only after conviction, which can be months to years after the initial arrest.

Considering the high rates of DWI recidivism and the cost to public safety, assessing DWI defendants alcohol use soon after arrest may have a significant impact on re-offending.  As such, we developed a screening, brief intervention and referral to treatment (SBIRT) program specifically for DWI offenders that could be delivered soon after arrest when motivation for behavior change may be high.  The aim of this project was to examine how easy and convenient it would be to implement this program during DWI Pre-trial orientation sessions that typically occur about 2 weeks after arrest.  Our program consists of a web-based self-guided screening tool for assessing: (1) quantity and frequency of alcohol use, (2) corresponding estimated blood alcohol concentrations, (3) drunk driving behavior, (4) family history of problematic alcohol use, (5) negative consequences experienced as a result of alcohol use, (6) risk for future health problems (7) estimated cost of DWI, and (8) strategies that may be useful to reduce alcohol use.  Based on the individuals responses, a personalized feedback report is generated and is then used to deliver a brief motivational intervention and if needed, a referral to treatment.

Between August and November 2014, 53.5% of all eligible offenders attending a DWI Pre-trial orientation volunteered to enroll in our program and the first 50 were asked to complete a usability and satisfaction questionnaire.  The results showed that the majority (73%) of those screened reported problematic patterns of alcohol use, requiring referral to alcohol use treatment.  In terms of the web-based screening tool, participants reported high ratings of usability with regards to how easy it was to use, the time it took to complete, how it looked and how easy it was to understand plus there were few minor technical difficulties.  Also, the majority of participants reported that the information provided in the personalized feedback report was easy to understand and was thought to be interesting, personally relevant, likely to increase motivation to change alcohol use and to impact drinking.  Overall, participants reported high levels of satisfaction with the full program.  The results of this study show that our SBIRT program may be effectively implemented within the criminal justice system to DWI offenders soon after arrest.  Our next steps are to examine if the program increases rates of offenders enrolling in alcohol use treatment and the impact it may have on re-offending.

 

Publication

Feasibility of a Computer-assisted Alcohol Screening, Brief Intervention and Referral to Treatment Program for DWI Offenders.
Mullen J, Ryan SR, Mathias CW, Dougherty DM.
Addict Sci Clin Pract. 2015 Nov 9

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