The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-related problems). It maps the treatment universe and for each sub-territory (a cell) lists the most important UK-relevant research and guidance. Across the top, columns move from specific interventions through how their impacts are affected by the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

What is this cell about?

Constructing local, regional or national systems featuring treatment (usually along with criminal justice procedures) for offenders whose offending is related to their drinking. In these contexts, treatment is offered or imposed not because it has been sought by the client, but because it is thought that treating their substance use problems could reduce crime or otherwise benefit the community. Also includes treatment systems which benefit the community in other ways, including protecting the drinker’s family and reducing the economic impacts of excessive consumption. As with commissioning in general, involves organising treatment provision to meet population needs in the context of resource constraints and national policy.

Research on treatment systems is rarely of the ‘gold-standard’, randomised controlled trial format. Whole areas and multiple coordinating agencies cannot easily be randomly assigned to implement new systems of care, while others must stand still or do the conventional thing to form a comparator; communities have their own lives, politics and event-driven diversions beyond the researcher’s control. Instead, researchers usually look for patterns in what naturally happens rather than manipulating it to test the consequences. All this cell’s key studies used variants on this methodology. Those patterns may reflect the presumed cause and effect mechanisms, but they may instead reflect unmeasured variables which randomisation would have evened up across intervention and comparison systems.

Treatment systems developed for criminal justice purposes are often derived from those centred on patient welfare and overcoming dependence; the impact of treatment in general on crime is the reason why it was adopted for criminal justice purposes. This means that for more research and ideas we can refer you back to cells dealing with brief interventions, treatment in general, medical treatments, and psychosocial therapies.