Abstract
BackgroundAlthough screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based technique that, in some health-care settings, has been shown to cost-effectively reduce alcohol and drug use, research on the efficacy of SBIRT among criminal offender populations is limited. Such populations have a high prevalence of drug and alcohol use but limited access to intervention, and many are at risk for post-release relapse and recidivism. Thus, there exists a need for treatment options for drug-involved offenders of varying risk levels to reduce risky behaviors or enter treatment.Methods/designThis protocol describes an assessment of SBIRT feasibility and effectiveness in a criminal justice environment. Eight-hundred persons will be recruited from a large metropolitan jail, with the experimental group receiving an intervention depending on risk level and the control group receiving minimal intervention. The intervention will assess the risk level for drug and alcohol misuse by inmates, providing those at low or medium risk a brief intervention in the jail and referring those at high risk to community treatment following release. In addition, a brief treatment (eight-session) option will be available. Using data from a 12-month follow-up interview, the primary study outcomes are a reduction in drug and alcohol use, while secondary outcomes include participation in treatment, rearrest, quality of life, reduction in HIV risk behaviors, and costs of SBIRT.Expected valueIndividual reductions in alcohol and drug use can have significant effects on public health and safety when observed over a large population at risk for substance-use problems. With wider dissemination statewide or nationwide, a relatively low-cost intervention such as SBIRT could offer demonstrated benefits in this population.Trial registrationClinical Trials Government Identifier, NCT01683643.
Highlights
Most people with a history of drug use enter the criminal justice system at some time in their drug use career, frequently on a recurring basis
The study supplements the brief intervention and the treatment referral components of SBIRT with a Brief treatment (BT) protocol for offenders who are at moderate risk or for those who are not willing to commit to longer-term treatment
Screening, brief intervention, and referral to treatment provides a bridge between primary prevention and treatment by conducting early identification and intervention with people whose current use may be low but who are at risk for future alcohol and drug problems and by referring those with likely abuse or dependence to longerterm treatment
Summary
Most people with a history of drug use enter the criminal justice system at some time in their drug use career, frequently on a recurring basis. Brief intervention, and referral to treatment (SBIRT) is an evidence-based technique that, in some health-care settings, has been shown to cost-effectively reduce alcohol and drug use, research on the efficacy of SBIRT among criminal offender populations is limited. Such populations have a high prevalence of drug and alcohol use but limited access to intervention, and many are at risk for post-release relapse and recidivism. There exists a need for treatment options for drug-involved offenders of varying risk levels to reduce risky behaviors or enter treatment
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