Alcohol-related violence: randomised trial of a brief intervention for offenders

Introduction: Oro-facial injury in violence is causally related to heavy alcohol consumption. A randomised trial of motivational interviewing of males with oro-facial injury has demonstrated effectiveness in reducing alcohol misuse (Smith et al, Addiction 2003;98:43-52), but this intervention has not been evaluated as part of offender rehabilitation, namely of those who cause oro-facial injury. Objectives: To evaluate the effect of a brief psychological intervention, delivered in a magistrates court, on violent males' alcohol consumption and misuse, offending and injuries. Methods: 269 males aged 16-35 years convicted of a violent assault whilst intoxicated were randomly allocated to intervention (motivational interviewing) or control conditions immediately following sentencing. At base line, three months and one year, offenders were assessed for alcohol misuse using the validated AUDIT questionnaire and consumption diary. Outcome measures were: readiness to change (RCQ), alcohol related harm (APQ), reoffending (UK Police Database) and injury (All Wales Injury Surveillance System AWISS). 87% of participants were followed up at three months, 75% at 12 months. Results: There were significant reductions in drinking at three and twelve months according to all measures of alcohol consumption (p>.001) but no significant between group differences on any of the alcohol measures or in terms of violent or other reoffending. Between group differences were significantly fewer A&E injury treatment episodes at one year and greater willingness to reduce alcohol consumption at three months in the intervention group (p=0.014, CI = 0.03, 0.25). Conclusions: A brief alcohol intervention immediately after sentencing for a violent offence whilst intoxicated had no effects on alcohol consumption or reoffending but increased willingness to reduce alcohol consumption at three months and reduced A&E attendance for the treatment of injury at one year. Funded by UK NHS Research and Development.