Alcohol, Driving and Crime - Health Care and Justice: An Outreach Intervention

Background

This communication aims to present the results of “Taxa.zero” Project developed in partnership between: Health Ministry - Lisbon and Tagus Valley Division for Intervention  on Addictive Behaviours and Dependencies (DICAD), Justice Ministry – two institutions: General Directorate of Social Rehabilitation and Prison Services (DGRSP), and the Public Prosecutor's Office of Lisbon Local Court for Minor Criminal Offenses. The project was intended for defendants indicted for the crime of driving a vehicle while drunk, that is, with 1.2 grams per liter of blood or higher of Blood Alcohol Concentration (BAC). In a logic of an integrated intervention between Health and Justice, this project aimed to create favorable conditions for the application of the “Taxa.zero” component to the aforementioned defendants, within the scope of Temporary Suspension of Judicial Proceedings.

Methods

The “Taxa.zero” component involves within the court facilities: an initial interview (DGRSP); a group session named “Alcohol and Driving Behaviour” (DGRPS and DICAD); and a final health assessment interview (DICAD). In the group session was explored the following themes: alcohol, driving and law, risk behaviours associated with alcohol use, effects of alcohol use, alternatives to driving when alcohol is used and risk reduction strategies.

After the group session, was made an individual health assessment interview, with an average duration of 30 minutes. The interview had an initial framing moment of the project, followed by application of the Alcohol Use Disorders Identification Test (AUDIT) and the discussion of its results with the interviewee, based on a motivational approach. The contents explored were the context that led to the risk behaviour, BAC in the situation that led to court, education for alcohol use and risk reduction strategies, health resources information, possible referral to specialized treatment and assessment of motivation for change.

Results

Between 2018 and 2023 we approached 828 people. The preliminary results are: the majority were male; the main risk context of driving drunk was recreational settings; the average BAC was around 1.54 g/l.; the majority were in low risk consumption (64%), followed by risky consumption (32%); 4% had high risk consumption and/or probable alcohol dependence; around 13% had indication for referral to treatment; 10% were referred and/or advised to maintain treatment and 46% of these accepted the referral proposal.

Conclusions

It was possible to outreach people that had difficulty reaching addictive behaviours health services, from an humanistic perspective. We increased health accessibility through an informative and counselling intervention for those who meet the criteria for referral to treatment. The relationship between Health and Justice was strengthened. In the future we must develop new strategies to increase awareness of the need for change and treatment for those who have indication for referral to treatment.