Alcohol Abuse is a Problem : Rural Term Paper

Alcohol abuse is a problem that is very consistent among individuals who are usually charged or convicted by the criminal justice system for violating the laws, yet there have been limited efforts to survey the effectiveness of diversionary programs for offenders whose crime is related to alcohol use. The criminal justice system has seen an increase in the rates of alcohol-related offenses particularly with the current trends in alcohol use among college students (Dale, 2007). This policy paper will review the available literature on alcohol diversion programs in rural communities.

The purpose of this paper is to explore the usefulness of alcohol diversion program in rural communities to identify the opportunities it provides to alcohol offenders especially those at risk of reoffending. The pattern of alcohol use among rural and urban folks will be assessed. Also, it aims to evaluate the different forms that these programs take and identify the interventions that are effective in reducing alcohol dependence and abuse. The findings of this paper will contribute to the lean information related to these expanding programs and likewise have direct implications for policymakers and stakeholders to improve the program.

Introduction

Surveys conducted in the United States, England and Australia propose that a significant proportion of those interviewed while in police custody are at risk for alcohol dependence and abuse (Zhang, 2004). Similarly, a recent systematic review of substance abuse and dependence among incarcerated offenders reveals that between 18 and 30% of surveyed male prisoners and 10 and 24% of surveyed female prisoners met criteria for alcohol abuse or dependence (Fazel, Bains, & Doll, 2006). These findings suggest that individuals who encounter the criminal justice system could benefit significantly from interventions to address alcohol abuse.

Alcohol abuse is related to a variety of negative consequences which includes trauma injuries, sexual assault, homicide, fatal motor vehicle crashes, fatal falls, suicides, and death. According to a report by the National Institute on Alcohol Abuse and Alcoholism, too much alcohol intake increases ones’ likelihood of being harmed. From this report, alcohol is a major factor in 60 percent of fatal burn injuries, homicides, and drownings. Also, 50 percent of sexual assaults and severe trauma injuries are caused by alcohol abuse. Hence, attempts to find ways to reduce these problems are important. One way to address alcohol abuse is diversion programs. However, we do not have much data on what works in the alcohol diversion programs.

Diversion programs have become increasingly popular in the United States as well as other Western countries to address several offenses including but not limited to drug offenses (Spohn et al., 2001; VanNostrand and Tewksbury, 1999), domestic violence offenses ( Johnson and Kanzler, 1993), intrafamilial child sexual abuse (Skibinski, 1994), shoplifting offenses (Deng et al., 1992), and juvenile offenses (Rose, 1997). Jail and court diversion programs give court-based services to first-time offenders with substance misuse disorders who are arrested for misdemeanor offenses. The primary goal of these programs is to ease access to the appropriate training or treatment services essential to enable offenders to change their behavior and make compensation without getting a criminal record. The alcohol diversion program uses education, community service, and support to work toward changes in behavior and cognition. The objective of these programs is to have the offender gain from the experience and avoid future contact with the criminal justice system. These programs primarily target nonviolent offenders and are used just when the case has been considered eligible by the judge or prosecutor and when the defendant accepts to enter the program. Once the defendant finishes the program successfully, the charges are dismissed and sealed (Broner, et al., 2005; Dale 2007; Steadman, Deane, et al., 1999).

Review of the Literature

Background

Rurality is a term that has become very difficult to define. Anytime we think about rurality the most evident characteristics that comes to mind is how low the population density is as compared to their urban counterparts. Rurality is defined as a place characterized by small population size and spatially separated from metropolitan areas (Brown & Schafft, 2011). Rural America represents a very significant portion of the American society and thus plays an active role in the growth of the country and the world at large. According to the U.S. Census Bureau 2006, the rural population share was about 17 percent, and this accounted for just about sixty million people.

The overrepresentation of rural people in the criminal justice system has over the years been a great concern. Studies have shown high levels of substance use among rural offenders (Joudo & Joudo, 2008). One significant area of interests to researchers, policy makers, and practitioners is the relationship between substance use and offending. This has served as a driving force for the expansion of diversionary programs and activities with the goal of addressing alcohol abuse; thus, reducing injuries as well as offending.

Diversion programs were created to provide offenders of certain crimes alternatives outside of traditional criminal justice systems (Walgrave, 1995). The program utilizes education, community service, and support to work toward changes in behavior and cognition of offenders. Substance abuse is a major issue in the criminal justice system. Although substance use among rural people is very prevalent, alcohol abuse is of greater concern to rural communities whereas illicit drug use is a major issue in urban areas. Diversion programs serve as a tool for increasing rural communities’ capacity to address alcohol use problems (Joudo & Joudo, 2008).

There is a scarcity of science-based studies with respect to the achievement of treatment strategies for alcohol abuse. This deficiency has been a problem to advance with respect to these social issues. The subject to be addressed will review the literature related to alcohol diversion programs in Rural America by discussing the patterns of alcohol use among rural and urban people, population that the diversion program serves, participants selection criteria, what triggered the involvement of participants in the program, the duration of the program, and screening and risk assessment instrument and interventions used in the program. Alcohol Diversion is a voluntary program which provides individuals charged for the first time for low-level, non-violent alcohol-related offenses the opportunity to avoid criminal sanctions by participating in targeted educational programs and undertaking some community services. Instead of being incarcerated, these alcohol abuse offenders are placed in treatment programs. Once the treatment is effective, these individuals can acquire skills that empower them to control their conduct while going about their daily lives.

Patterns of Alcohol Use among Rural and Urban Dwellers

The Alcohol Research: Current Reviews journal discussed in their study on “Alcohol use patterns among urban and rural residents” that an individual’s geographic location affects their rates of alcohol use disorder. In this study, it was argued that social and cultural factors are significant when considering geography as they also influence the rate of drinking among particular residents.

Factors or conditions such as accessibility to alcohol, norms for appropriate drinking behaviors, demographic attributes, and economic status were defined in the journal as significant conditions that influences the rates of drinking across urban and rural communities. Comparing urban people with rural people, the journal discussed that both were more likely to report alcohol use over their lifetime. It has been observed in previous studies that suburban residents would in general be more abstinent compared to their rural and urban counterparts. However, rural drinkers were more likely than suburban drinkers to report drinking rates above the suggested daily drinking limits. The study found that men in rural areas would take not less than four drinks in a sitting. Rural women also would consume not less than three drinks in a sitting. Similarly, it was also revealed that in a regular week, men in urban areas were more likely than men in suburban areas to consume more than 14 drinks and urban women consuming more than 7 drinks compared to their suburban counterparts. Both rural and urban drinkers are likely to report similar risks for lifetime alcohol dependence (Grant 1997).

In terms of problematic drinking, the journal revealed that drinkers in rural areas compared to drinkers in suburban areas were more likely to report an alcohol use disorder episode in the past year at 15.1% to 11.6%. In the urban areas, 14% reported having such an issue. The researchers concluded that both rural and urban drinkers had similar rates of alcohol use disorder, but the urban drinkers had higher rates of alcohol use than rural drinkers (Dixon & Chartier, 2016).

Population and Selection Criteria

Alcohol diversion programs are primarily designed for people who have been charged with non-violent alcohol-related offenses. This includes adults, college students, and non-college peers. Notwithstanding the target population for this program, various studies have shown that the program tends to serve college students and non- college peers more especially in communities with colleges.

A study published in the Journal of Substance Use reviewed the Rural Alcohol Diversion (RAD) program in rural New South Wales, Australia. This program was designed by the magistrate court to offer treatment programs for adult defendants with history of problematic alcohol use. The treatment is offered to them during their bail period. A defendant did not have to admit to an offense for referral or acceptance into the RAD program. The program accepted people charged with various offences except for those charged with violence or sexual assault and on condition that the defendant could have his case heard at a local court. Upon referral by the court, the defendant had the right to decide whether to participate in the program or not. Out of the 202 participants studied in this program, it was revealed that 174 (86%) were males. The median age for the participants was 31 years for a range of 18 to 59 years (Martire & Larney, 2011).

Dale (2007), studied the diversion program of Nelsonville County and found that the city’s arrest record for alcohol and other drug offenders were mostly first year college students which is consistent with research showing that heavy drinking among young adults mostly occurs in the first few years after high school and that the rates of college students’ heavy drinking surpass those of their noncollege peers (Schulenberg et al., 1996). His study showed that in the years 2003 through to 2005, nearly 70% of diversion program participants were college students. The remaining 30% included local residents, transients, and referrals from other courts that considered the Diversion Program appropriate for offenders who qualified for this type of intervention.

The Duration of the program

Recommendations

Alcohol abuse is rural communities is an issue that will be very difficult to eradicate entirely. Based on the review of literature on alcohol diversion program, I offer the following recommendations or strategies to help ensure effective alcohol abuse prevention in rural communities.

1. As it was observed, eligibility criteria are the most significant barrier to rural people accessing diversion programs. It is important that policymakers of the program review and amend these criteria to enable people who violate alcohol policies as well as have drinking problems get access to treatment.
2. Additional considerations for improving access would be to ensure the wider dissemination of information about diversion programs among rural communities.
3. It is also recommended that the duration for the intervention programs be increased for individuals arrested for alcohol-related offenses to address not only the presenting problems of alcohol abuse but also effectively help offenders process and navigate emotional developmental issues that have influenced their thinking and behaviors pertaining to the use or abuse of substances.
4. Further, I recommend that individuals especially youths charged with alcohol-related offenses and eligible for diversion program should at the initial stage be screened and assessed to detect their involvement with alcohol and other substance. Again, where there is the need for further assessment and treatment, these individuals should be made to take it.
5. It is also recommended that people who have been trained and have experience in counselling, treatment, and life style management skills be made to administer alcohol interventions to people referred to alcohol diversion program.

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