Screening Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that has been found to be effective in reducing alcohol and illicit drug use, mainly among persons recruited in medical centers, primary care offices, emergency rooms, and colleges and universities. But SBIRT has the potential to be applicable to other populations that have, or that are at risk for, substance use problems. In particular, offenders have high prevalence of drug and alcohol use at varying levels of severity and often do not receive adequate intervention, either because of limited availability of programs, low motivation, or lack of awareness of the consequences of their substance use. The study proposes to test the effectiveness of an SBIRT intervention with jail inmates, with the goal of improving public safety and public health. Building on previous and current research on treatment for substance-abusing offenders and on the infrastructure established by a SAMHSA-funded SBIRT study with jail detainees in Los Angeles, the UCLA Integrated Substance Abuse Programs (ISAP) is proposing a four-year randomized field study to examine the effectiveness of SBIRT with offenders who have been convicted and are about to be released from jail. We will recruit inmates at two jail facilities in Los Angeles County, one for men and one for women, and randomly assign them to the treatment (SBIRT) group (N= 400) or to the control (no intervention) group (N = 400). Baseline demographic data will be collected. Twelve months after study admission, all study participants will be contacted for a follow-up interview. The experimental study will use manualized intervention components, will be implemented within a community setting (jails and a local community treatment system), and will thus attempt to give due consideration to issues of both internal and external validity. To our knowledge, this would be the first rigorous test of SBIRT with an offender population. The scientific aims of the study are: (1) Assess the effectiveness of SBIRT with jail inmates in terms of participation in a graduated series of interventions (brief intervention, brief treatment, and referral to longer-term treatment) depending on risk level. (2) At 12 months after study admission, determine the effectiveness of SBIRT with jail inmates on public health and public safety outcomes, namely, drug use, alcohol use, criminal activity, arrest, reincarceration, HIV risk behaviors, and quality f life.(3) Determine the cost of providing an SBIRT intervention to jail inmates.
Using a screening, brief intervention, and referral to treatment (SBIRT) approach, this study is intended to impact the drug and alcohol use and the HIV risk behavior of an offender population by providing a graduated series of interventions for low-risk, medium-risk, and high-risk offenders. If successful, the study would demonstrate that SBIRT can have a positive effect on the drug use behavior and related health and psychosocial behaviors, as well as on criminal activity and criminal justice involvement.