To reduce its prison population, South Dakota created the unique 24/7 Sobriety program, which focused its attention on a precise slice of its offender population — those whose crimes involved alcohol. Very simply, the program required these offenders to abstain from drinking while on probation. A National Institutes of Health-funded study examines the impact of this program and finds it to be associated with a 4 percent drop in state deaths. 

The 24/7 Sobriety program was piloted in select South Dakota counties during 2005, explain the researchers. Anyone whose drinking had threatened public safety would be subject to the program, which entails wearing alcohol-monitoring bracelets or submitting to twice-a-day breathalyzer tests, typically 12 hours apart. Though twice-a-day testing cannot detect every instance of drinking, it does identify heavy drinking.

“Participants who test positive or skip a test are subject to an immediate, but brief jail term (typically one or two days for a failed test),” noted the research team led by Nancy Nicosia, a senior economist at RAND, the nonprofit research organization that conducted the study.

Exactly 16,932 people — nearly 3 percent of South Dakota’s adult population — participated in the sobriety program between January 2005 and June 2011. About half of these participants were repeat DUI offenders; the remainder had been charged with assault, domestic violence, or a first-time DUI. The average length of participation was 122 days for those assigned to twice-daily breathalyzer tests and 184 days for those assigned to continuous monitoring devices.

After crunching the numbers, the researchers discovered implementation of the program related to a reduction in all-cause mortality by 4.2 percent, concentrated among women and people over the age of 40.  Reductions in death were most obvious for maladies sensitive to alcohol, such as circulatory conditions.

Because only 3 percent of the adult population participated, yet the results were a good percentage point higher than that, the researchers say further study is needed, though they speculate partners and close friends of anyone court-ordered to remain sober may have reduced their own drinking as well.

A previous study of the 24/7 program revealed it had reduced domestic violence arrests by 9 percent and repeat DUI arrests by 12 percent. "Policy interventions that alter heavy drinking among at-risk populations might have appreciable effects on mortality," concluded Nicosia and her colleagues. Currently, the program is being implemented in other states, while a modified version was recently piloted in London.

Source: Nicosia N, Kilmer B, Heaton P. Can a criminal justice alcohol abstention programme with swift, certain, and modest sanctions (24/7 Sobriety) reduce population mortality? A retrospective observational study. The Lancet Psychiatry. 2016.