Estimating the Effect of 24/7 Sobriety on Morbidity and Mortality in North Dakota

项目总结 酒精与醉酒、依赖和精神疾病引起的发病率和死亡率有关。 酒精使用对器官和组织的生物学后果。酒精和疾病之间的关系是 尤其令人担忧的是那些表现出重度饮酒的人。疾控中心估计，8万人 在美国，每年因过度饮酒而死亡的人数居第三位 与生活方式有关的死因。酒精的使用在刑事司法人群中尤其成问题，因为 是与酒精有关的不良后果，如死亡。虽然这些问题已经有了很好的记录， 到目前为止，确定有效减少与酒精有关的危害的战略的努力取得了好坏参半的结果。 结果好坏参半，部分原因可能是这些干预措施针对这些饮酒者的程度。 最有可能经历或施加伤害的情况以及干预措施成功减少的程度 喝酒。该项目的目标是确定北达科他州为罪犯提供的全天候戒酒计划 在实施该计划的县中，正义罪犯降低了发病率和死亡率。 北达科他州的24/7戒酒计划(以下简称ND 24/7)应用了频繁饮酒的概念 测试与对居住在美国的违法者迅速、确定但温和的制裁相结合 社区。参赛者必须每天接受两次酒精测试或连续饮酒。 监控手镯。那些检测呈阳性或漏检的人将面临立即但短暂的监禁。这个 该计划的主要目标是减少这些人口和刑事司法机构的酗酒 他们饮酒的后果(例如，重复酒后驾车)。虽然它们还没有得到严格的研究，但 该计划的影响很可能延伸到其他与酒精相关的结果--发病率和死亡率 是最昂贵的之一。利用ND在实施计划的时间上的差异 县，我们将采用准实验的方法来确定该计划是否影响 急诊室就诊、入院和死亡率。我们还将评估实施情况 特征(例如，测试、暴露)会影响结果。然后我们将使用这些发现来构建一个衡量标准 该计划的好处。 这项研究的目标是为政策制定者和其他利益相关者提供对 程序。这项拟议的研究在关注与健康和死亡相关的后果方面具有创新性。 有针对性的干预措施，以减少与饮酒相关的不良后果 把最大的代价强加给他们自己和社会。拟议的研究小组是唯一有资格进行 这项研究。他们目前正在评估ND 24/7‘S对酒后驾车的影响。以及他们由NIAAA资助的对 南达科他州的全天候戒酒计划表明，南达科他州的计划减少了酗酒， 因此，年轻男性中反复发生酒后驾车逮捕、家庭暴力逮捕和交通事故。

PROJECT SUMMARY Alcohol has been linked to morbidity and mortality resulting from intoxication, dependence and the biological consequences of alcohol use on organs and tissue. The relationship between alcohol and disease is especially concerning among those who exhibit heavy drinking episodes. The CDC estimates that 80,000 deaths are attributable to excessive alcohol use in the U.S. annually, making alcohol use the third-leading lifestyle-related cause of death. Alcohol use is particularly problematic among criminal justice populations as are alcohol-related adverse consequences such as mortality. While the issues have been well-documented, efforts thus far to identify strategies that effectively reduce alcohol-related harms have produced mixed results. The mixed results may be explained, in part, by the extent to which these interventions target those drinkers most likely to experience or impose harms and the extent to which the interventions successfully reduce drinking. The goal of this project is to determine whether North Dakota's 24/7 Sobriety Program for criminal justice offenders reduced morbidity and mortality in counties that implemented the program. North Dakota's 24/7 Sobriety Program (hereafter, ND 24/7) applies the concept of frequent alcohol testing in combination with swift, certain but modest sanctions for alcohol violations to offenders living in the community. Participants must submit to breathalyzer tests twice per day or wear continuous alcohol monitoring bracelets. Those testing positive or missing a test face an immediate, but brief, jail term. The program's primary goal is to reduce heavy drinking among this population and the criminal justice consequences of their alcohol use (e.g. repeat DUI). Although they have not yet been studied rigorously, the effects of the program are likely to extend to other alcohol-related outcomes – with morbidity and mortality being among the most costly. Exploiting variation in the timing of the program's implementation across ND counties, we will employ quasi-experimental methods to determine whether the program influenced emergency room visits, hospital admissions and mortality. We will also assess whether implementation features (e.g. testing, exposure) influence outcomes. We will then use these findings to construct a measure of the program's benefits. The study's goal is to provide policymakers and other stakeholders with rigorous analyses of the program. The proposed study is innovative in its focus on the health- and mortality-related consequences of a targeted intervention to reduce the adverse consequences associated with alcohol use among those likely to impose the greatest costs on themselves and society. The proposed study team is uniquely qualified to conduct this study. They are currently evaluating ND 24/7's effects on DUI. And their NIAAA-funded evaluation of South Dakota's 24/7 Sobriety Project indicated that the South Dakota program reduced heavy drinking and, consequently, repeat drunk driving arrests, domestic violence arrests, and traffic crashes among young males.