Alcohol and criminal acts, particularly violent crime are closely connected. The number of law breakers has increased. Many are incarcerated because of committing crimes related to alcohol consumption. Alcohol is illegal in prisons with the exception of a very few situations, and illegitimate consumption of alcohol in prison remains a minor issue. However, imprisonment offers an opportunity to deal with problems related to alcohol among prisoners, with a high prospective of positive results on their friends and families minimizing the risk of re-offending, health inequalities, and the costs to society. The aim of this research is to examine the effectiveness of the screening tool AUDIT in detection of health problems caused by alcohol among prisoners. This paper presents the questions that the research intends to answer, the significance and relevance of the study of the subject, including a review of available scholarly sources related to the subject.
Examining the Effectiveness of AUDIT in Detecting Alcohol Related
Health Problems among Prisoners
Aims and objectives
The long-term objectives of this proposal are to minimize future alcohol use and related crimes committed by incarcerated persons by developing relevant interventions and creating a better perceptive of the role screening tools play in identifying alcohol related health problems among such. Their effectiveness will be displayed through timely and proper identification of health problems caused by consumption of alcohol and reduced cases of these problems among research participants in comparison to those screened using other tools.
The objectives of the study are;
To examine the effectiveness of the screening tool AUDIT for identification of alcohol related health problems among the correctional population.
To identify relevant interventions that will assist in minimizing future alcohol use and related crimes by incarcerated persons.
Background and Significance of the Study
Alcohol-related problems are most efficiently detected by the use of an authentic screening tool. However, partial evidence exists regarding the effectiveness of screening tools in reformatory institutions since alcohol problems are frequently extended to incorporate substance abuse. Nonetheless, Alcohol Use Disorders Identification Test (AUDIT), a screening tool developed by the World Health Organization (WHO), has emerged as the most capable preference in busy surroundings due to its escalating use in criminal justice environments both for practice and research and its capacity to distinguish between diverse patterns of drinking behavior.
In recent times, a rising number of high-quality researches have been published, mostly concerning young offenders and female prisoners. In general, the strongest evidence currently points to motivational interviewing and short interventions that relate to alcohol, even though the unevenness in content and length of these interventions across research makes it tricky to specify recommendations for implementation. A brief intervention is essential because it is a small, opportunistic intervention conveyed empathetically, in addition to motivational aspects, by a well trained practitioner. This makes brief interventions an appropriate method for prisoners that may lack enough time to access other prison-based alcohol services, either due to the nature of their problems or short period of their stays.
Recent study on brief interventions in most criminal justice environments like probation has indicated declines in reoffending and consumption of alcohol. The examination of the evidence has drawn attention to the necessity for more vigorous research across the array of likely interventions for alcohol problems in the criminal justice system. Remarkable gaps exist in the studies regarding the prevention of relapse and cost–efficiency. In addition, an investigation into the associated problems such as drug use, mental health problems, and violent offending would be valuable. The cooperation and coordination of future research relating to this subject would be useful and effective.
Four Key Themes
The effectiveness of screening might depend on both what is done and how screening is conducted. Concerning “what”, the research evidence shows that cognitive behavioral methods of screening provide the best options for success.
Any type of intervention is only effective when delivered according to their present reports of best practice and conducted by a skilled practitioner. The availability of trained practitioners predicts assumptions gathered from the evidence.
The evidence base for the success of interventions related to alcohol problems is strong. The research is significant and merits additional financial aid to research programs.
There is a range of effective treatments that are appropriate to the array of likely service users. This may also be the use of more rigorous treatment delivered by expert practitioners and brief interventions delivered by generic practitioners in the criminal justice system upon screening.
The AUDIT was developed by the World Health Organization (WHO) particularly for usage in primary healthcare (Saunders et al., 1993). However, it is currently used in a variety of settings, cultural groups and populations and has led to a lot of research in many areas of study (Allen et al., 1997). It is presently used in practical and research applications throughout the world. This screening tool is composed of ten items; four questions on alcohol-related problems and undesirable reactions, three on alcohol consumption, and three on symptoms of alcohol dependence. An AUDIT questionnaire requires about two minutes filling in, and most of the items are related to alcohol consumption in the preceding year, and answerers are weighted on a scale of 0–4, based chiefly on frequency of occasion.
Borrowing widely from research conducted in the United Kingdom, specifically in Scotland, a comprehensive framework of care for alcohol-related problems in prisoners is explained including elements for best practice. This framework is developed based on the theory that health care in the criminal justice system should be correspondent to that within the outside community and suggests three stages of assessment. The first stage involves screening (using AUDIT), and subsequently triage, which aids to point persons into the most suitable level for intervention. Triage is supposed to establish the existence of other co-occurring social or health problems including risk and can also assist to prioritize those that need intervention most in terms of high demand. Individuals drinking at risky or harmful levels (indicated by AUDIT scores of 8–19) are usually presented with one or more tier one and two interventions as suitable. These may perhaps comprise motivational interviewing and brief interventions. Individuals with AUDIT scores exceeding twenty show signs of a greater probability of alcohol dependence and ought to undertake a comprehensive review. They may undergo more intense interventions at tiers three or four, for instance psychological therapies.
Lapham (2004) identifies alcohol-related health problems among a high percentage of lawbreakers in the criminal justice system. The study concludes that it is sensible to execute brief interventions and alcohol screening programs for individuals in this setting, specifically for impaired driving lawbreakers, who have high chances of being alcohol dependent. However, little effort has been put into establishing ways of improving the screening procedure and extending it to cover the whole criminal justice population. For instance, the subjects concerning the prospective therapeutic gain of the screening procedure and the means of incorporating brief motivational interventions into this procedure to advance outcomes require more research (Lapham, 2004). In order to deal with this, more effort should be put into the development and implementation of relevant principles for screening programs in the criminal justice system, assessment of the effectiveness of current programs, and making sure that these programs offer sufficient treatment services to prisoners. However, this study examines the validity or reliability of screening tools used in the prison areas, but fails to identify one limitation to the effectiveness of existing screening procedures- they are not intended to assess offenders (Lapham, 2004).
A major issue for all screening tools is whether to focus on the whole population or at-risk groups. In two articles written by Beich, Gannik & Malterud (2002) and Beich, Thorsen & Rollnick (2003), the authors conclude that screening leads to more problems than it resolves and does not show prospect of being an efficient antecedent to brief interventions focused on excessive use of alcohol. These findings have been widely disapproved of leading to an intense argument. Alcohol Harm Reduction Strategy for England recommends targeted screening as opposed to universal screening (Prime Minister’s Strategy Unit, 2004). A survey of professional views on brief interventions and screening in primary healthcare in the UK shows a straight consensus among professionals on confinement of custom screening to new patients, special tests and general screening. This conclusion is also backed by the findings from target groups among patients and primary healthcare experts.
The study will adopt quantitative research design, which will involve 70 imprisoned participants aged 18 and above who take alcohol and suffer from health instigated health problems. This design is ideal since it allows fresh data collection that facilitates aggregate numerical analysis of the effectiveness of the screening tool. Participants in this research will complete structured questionnaires pertaining to; (1) their alcohol consumption quantities and its related outcomes, (2) the adverse health problems they have faced as a result of taking alcohol for a specific period of time, (3) the details and effectiveness of any screening tools, and treatment that might have been used on them and (4), their opinion on the effectiveness of the screening tool AUDIT and any benefits they may have derived from the instrument. Data collection will take place within two weeks and will be analyzed in percentages, ratios and presented using charts.