Derbyshire Community Safety Partnership, Druglink.
Derbyshire Community Safety Partnership and Druglink, 2011.
Enticed by a halving in their fines, young 'binge' drinkers in northern England penalised for alcohol-related nuisance undertook a brief course which was followed by substantial reductions in drinking and alcohol-related problems. The fines they did pay financed the courses.
Summary The Alcohol Diversion Scheme in Derbyshire in northern England was created to deliver a brief intervention within a prevention model achieving behaviour and attitude change towards alcohol consumption among 'binge' drinkers. The scheme was commissioned by the Derbyshire County Council Community Safety Partnership and Derby City Community Safety Partnership. The first course was delivered in March 2010.
The primary target group are 18–25-year-old 'binge' drinkers in the process of being fined a fixed penalty of £80 for causing a nuisance linked to drinking. Offenders' details are transferred electronically to the charitable drug misuse service Druglink, which contacts them through an assertive marketing scheme and invites them to attend an educational programme. The incentive is that attendees are offered a 50% reduction in their fine. The £40 they do pay finances the scheme, which therefore requires only set-up costs.
In its first year of operation, 97 individuals completed 13 courses. These educational sessions are run once a month at various locations and focus on four learning outcomes:
• the link between alcohol and violence;
• understanding alcohol units; A UK unit is 8gm alcohol.
• the implications of the offence and penalty for the offender's future;
• the physical harms of alcohol; and
• the psychological harms of alcohol.
Participants were mainly young men. Just over half were employed. About 9 in 10 had been involved in alcohol-related physical violence and 14% had attended a hospital emergency department for an alcohol-related issue in the past year. On the AUDIT questionnaire, 47% scored as harmful drinkers and 30% scored 15+ which indicates a relatively severe drinking problem. Half had used other drugs as well as alcohol on the night they received their penalty, most commonly cannabis, cocaine or prescribed medications. Of the 97, 32 completed follow-up interviews six to ten months after their courses, the basis for the longer term outcomes and views on the courses recorded below.
Average alcohol consumption before the course of 36 units per week had been reduced at follow-up to 15 units, just 11% of interviewees were still drinking above safe guidelines, and from drinking four days a week, they were now drinking twice a week. An average pre-course score of just over 13 on the AUDIT questionnaire had been reduced by 17.5% to 11. Attendees reported actively managing and reducing frequency of consumption; they considered this a key element of managing their drinking and reducing incidents of binge drinking.
Related to their drinking, before their courses interviewees had been admitted a total of 84 times to a hospital emergency department. There were no such admissions in the follow-up period. Also reduced to zero was the proportion of interviewees (previously two thirds) who had an alcohol-related sexual encounter in the form of a 'one night stand' and the proportion (previously 78%) who had been involved in some form of physical altercation when under the influence of alcohol. Interviewees reported using techniques learnt during the course firstly to identify potentially threatening situations and then to successfully walk away and not be drawn into violent incidents. All those interviewed said they had not committed a further alcohol-related offence since attending the course.
Before attending the course, interviewees saw their penalty notices as being as inconsequential as a parking ticket. Following the course, virtually all now realised they could receive a conviction possibly resulting in a custodial sentence for a subsequent alcohol-related offence, understood the link between their drinking and their offending, and said the course had significantly increased their knowledge of the risks of binge drinking. Interviewees particularly valued learning about the possible sanctions for re-offending, being helped to understand the relation between their drinking and their being given a penalty notice, understanding alcohol units, and learning about the physical and psychological effects of drinking and triggers to binge drinking.
Self-sustainably and at no ongoing cost to the wider public, the scheme effectively engages binge drinkers and delivers meaningful behaviour and attitude change, resulting in significant health and offending improvements. Amongst others, cost-savings can be expected to accrue to emergency departments, police, courts, and services dealing with unwanted pregnancies and sexually transmitted diseases. A key objective of the scheme is to curb alcohol-related anti-social behaviour. This it does in part by bringing home to participants – in a way which merely receiving the penalty does not – the seriousness of their offence, and enabling them for the first time to look at the incident and make the connections with their drinking and their behaviour. From merely feeling they have been victimised by the police, they are able to recognise that their drinking resulted in inappropriate behaviour which invited arrest.
commentary The authors plausibly link learning from the course to subsequent outcomes, lending weight to the contention that outcomes would not have been so good from the penalty process on its own. However, without a control A group of people, households, organisations, communities or other units who do not participate in the intervention(s) being evaluated. Instead, they receive no intervention or none relevant to the outcomes being assessed, carry on as usual, or receive an alternative intervention (for the latter the term comparison group may be preferable). Outcome measures taken from the controls form the benchmark against which changes in the intervention group(s) are compared to determine whether the intervention had an impact and whether this is statistically significant. Comparability between control and intervention groups is essential. Normally this is best achieved by randomly allocating research participants to the different groups. Alternatives include sequentially selecting participants for one then the other group(s), or deliberately selecting similar set of participants for each group. group of similar offenders not offered access to the courses, it is impossible to be sure this was the case. The other major limitation in the study is that just a third of course participants were followed up.
Thanks for their comments on this entry in draft to Sue Green of Druglink Ltd in Hemel Hempstead. Commentators bear no responsibility for the text including the interpretations and any remaining errors.
Last revised 06 September 2011