Brief, effective interventions are needed to reduce the risk of an alcohol-exposed pregnancy in women who drink and do not use effective contraception. The Healthy Choices study compared telephone and in-person administration of a brief intervention. In addition to indicators of alcohol use and effective contraception, compliance with the intervention was examined. Women between the ages of 18 and 44 who were drinking above recommended levels and not using effective contraception were randomly assigned to either a telephone (n=68) or in-person (n=63) brief (2 session) intervention. Overall, participants showed small but significant reductions in alcohol use and larger increases in effective use of contraception. Risk of alcohol-exposed pregnancy was thus significantly reduced, largely due to improved contraception with minor reductions in alcohol use. There was no significant difference in success of the intervention between the two conditions (telephone vs. in-person). These findings suggest telephone-based brief intervention may be equally successful and cost-effective in reducing the risk of an alcohol-exposed pregnancy and thus fetal alcohol syndrome.

Recognizing the relationship between substance abuse and criminal behavior, the Wisconsin legislature in 1989 mandated the establishment of the Treatment Alternative Programs (TAP) modeled after the national Treatment Alternatives to Street Crime (TASC) program. This study evaluates the economic impact of TAP by examining the benefits and costs and cost-effectiveness of diverting offenders from the criminal justice system into substance abuse treatment. The results suggest that the benefits of TAP outweigh its costs in the short run and TAP costs less than incarcerating offenders.

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This study investigated treatment retention in an institutional therapeutic community (ITC) for dually diagnosed male inmates. Twenty-five percent of admissions successfully completed the residential substance abuse treatment program. Graduates participated for an average of 9 months, while terminations participated for nearly 4 months. One-third of the terminations participated for at least 3 months and 15% participated for 6 months or more. A striking result was the relationship between retention and risk ratings and psychopathy scores. Both measures assess behavior and interaction styles over a range of situations. The presence of a single type of negative behavior (i.e. the nature of the committing offense) did not predict completion, but a rating based on multiple samples of behavior was a significant predictor of retention.

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