Transdermal Alcohol Monitoring (TAM) in compliance with abstinence: Records from 250,000 offenders in the United States

Heavy drinking is associated with a number of public health and criminal problems including driving-under-the influence (DUI), suicide, domestic violence, and other violent crimes. Offenders with a history of alcohol-related offenses entering probation programs are likely to meet the criteria for alcohol abuse or dependence. Consequently, many probation programs in the United States (U.S.) require abstinence from alcohol for these chronic offenders. The development of technology that detects and quantifies alcohol eliminated through the skin (transdermal alcohol monitoring [TAM]) has recently provided the capability for courts to enforce abstinence at a relatively low cost. The Secure Continuous Remote Alcohol Monitoring (SCRAM™) ankle bracelet device is the most widely used TAM unit on the market. The records of approximately 250,000 alcohol offenders in the United States are currently being analysed. Eighty percent of the offenders on the SCRAMTM have been males and 5% have been younger than age 21. Approximately 172,500 of the offenders placed on the SCRAMTM units have been DUI offenders. Rates of drinking violations and tampering with the device are highest for males (25%), offenders aged 35 to 54 (27%) and for African Americans (31%). The SCRAMTM unit is an innovative technological device which makes possible the management of a behavioural change program that has received wide acceptance by the U.S. criminal justice system. However, this has been achieved without an independent evaluation of its effectiveness in producing a change in drinking behaviour that persists beyond the termination of the program. TAM devices, such as the SCRAMTM unit, have the potential to (a) help judges, court and probation officials monitor the abstinence requirement of various offenders and impose swift sanctions for non-compliance; (b) help offenders with alcohol abuse and addiction issues to remain abstinent while they are receiving professional treatment for their alcohol problem; (c) reduce DUI recidivism and improve public safety; and (d) provide a cost effective alternative to incarceration for many alcohol offenders.