As Owen Jones recently highlighted in his article ‘The Drug we ignore that kills thousands‘ alcohol has taken the lives of at least 5,000 English and Welsh citizens every year for the last decade. It is a potentially lethal substance that kills 2.5 million globally, and damages the health of far, far more. Moreover, as well as the human toll, it costs the British economy £21bn a year in crime and healthcare.
Considering that while £1,313 is spent on treating every dependent drug user, just £136 is reserved for every dependent drinker, we looked at how alcohol testing can help tackle the problem.
Embracing new technology
Currently there is still a heavy reliance on self-reporting drink diaries, which are very open to misreporting. When objective testing is employed, more traditional methods of alcohol testing, such as breath or urine only provide a very short window into the clients consumption. This presents some real problems to the professionals involved in the treatment of alcohol misuse, as a full picture of the problem cannot be obtained.
However, a new alcohol testing method to the UK called Transdermal Alcohol Continuous Testing (TACT) is helping to solve this problem. Whilst it was only introduced to the UK in 2012, TACT has been in use in the US for over 10 years and has proven very successful in the US through sobriety courts, mainly for persistent drink drivers.
Paul Ennis (Market Development Manager at Alere Toxicology) worked as a Substance Misuse Outreach Multidiscipline Team Manager for The Phoenix House Group for 10 years and explains how TACT can help alcohol workers implement effective treatment programmes.
TACT can be used as an evidential drinks diary for users to see if their drinking is within healthy limits. This information can enable users to reduce the amount they consume and allows treatment providers to accurately use appropriate interventions.
Another application is in aiding one to one cognitive behavioural programmes for problematic drinkers, where drinking is linked to offending. The ASAR (Alcohol Specified Activity Requirement) is one area within healthcare that has already shown an interest, as TACT will allow the alcohol worker and the offender to understand the triggers that cause relapse and increase their understanding of offending and alcohol use.
How does TACT work?
TACT works by testing for alcohol transdermally (through the skin) every 30 minutes using a SCRAM™ bracelet worn on the ankle. The SCRAM™ bracelet analyses insensible perspiration to determine whether a person has consumed alcohol, when alcohol is consumed it is broken down in the liver, which removes 95% of alcohol from the body. A small amount of it, about 1%, avoids metabolism in the liver and is excreted through the skin (insensible perspiration). Insensible perspiration is perspiration that is produced by the sweat glands in the skin, which will then evaporate.
Testing data is stored within the bracelet and can either be uploaded wirelessly every 24 hours or manually downloaded as often as is required. The bracelet contains various tamper proof mechanisms which alert the supervising organisation if tampering takes place.
The benefits of TACT
TACT can provide a definitive picture of when and how often a person is drinking over a given time period, assisting at the assessment stage. If professionals are able to see this level of detail at an early stage then the overall treatment plan can be tailored to the level a particular person is drinking.
As SCRAM™ is an ankle bracelet; it goes where your client goes. This eliminates the need for the client to repeatedly report to a testing centre and eliminates testing gaps, as there is no ability to miss a test or drink around a testing schedule.
In the US it has proven to be a successful motivational tool for those wanting to reduce the amount they drink or those who want to remain sober. According to data from the 300,000 offenders monitored with SCRAM technology, 99.3% of all offenders, every day, are completely sober and compliant. No drinking, no tampering.
TACT use in the UK
TACT is being used in various capacities throughout the UK, one of these is within the family courts where definitive evidence of sobriety is required. The more widely used methods of hair and blood testing are limited in the evidence they can provide and TACT has provided another level of detail that allows solicitors and social workers alike to make informed decisions on how their case should proceed. An article last year in Family Law Week discussed the alcohol testing options available and the advantages and disadvantages of each.
There is also a pilot taking place within London that is trialling the effectiveness of the technology within domestic violence cases. Another pilot is due to start in London later this year which will trial the introduction of Alcohol Abstinence Monitoring Requirements (AAMR), where people committing alcohol related crime could be ordered to abstain from alcohol. So that this can be imposed it has been written into sections 76 and 77 of the Legal Aid, Sentencing, and Punishment of offenders (LASPO) Act 2012.