Doctors and recovery experts say more must be done to support people with alcohol problems who end up in the criminal justice system.
Prisoners and other individuals who have contact with the police and courts are much more likely than the general population to have an alcohol use disorder.
Scottish Health Action on Alcohol Problems (SHAAP), an umbrella body of clinicians, argues that a proactive approach to tackling alcohol misuse in this group has the potential to reduce re-offending rates, as well as addressing health inequalities.
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It comes as statistics revealed that alcohol deaths in Scotland remain at a 14-year high of 1,276 in 2022, with mortality rates from alcohol more than four times higher in the most deprived communities compared to the most affluent.
September is recognised internationally as Recovery Month.
SHAAP has written to the Cabinet Secretaries for Justice and Health to call for a range of initiatives including automatic referrals to healthcare or alcohol treatment services for anyone identified in police custody as having an alcohol use disorder, wider use of alcohol treatment orders as part of community sentences, and the expansion of the Alcohol Courts model first piloted in Glasgow in 2018.
The court, which sits once a week at Glasgow Sheriff Court, refers offenders whose convictions - such as violence, domestic abuse, or driving offences - relate to their alcohol abuse onto a criminal justice social worker and a substance misuse worker for "intensive support".
They are subject to alcohol counselling treatment and regular supervision for up to two years.
There are also Alcohol Courts based in Edinburgh and Hamilton.
SHAAP's recommendations come after it convened an expert working group with representation from a range of public health, recovery, and justice organisations, including Police Scotland, the Scottish Prison Service, and the Scottish Recovery Consortium.
Dr Lesley Graham, SHAAP steering group member and former public health doctor, said: “While it’s well-known that people with alcohol problems are hugely over-represented in the justice system, more could be done to support people in relation to their alcohol problem and to reduce the significant inequalities people in this situation face.
"We have found that while there is already much policy and guidance that can be used to provide support and treatment for people with alcohol problems, there are significant gaps in implementation.
"This is understandable given the strain our health and justice systems are currently under but if time was invested in providing the right kind of support for people with alcohol problems earlier in their journey, not only is it likely to reduce reoffending but it would improve the health of people with alcohol problems.”
She said: “It is key that lived experience recovery organisations are involved in every stage of the justice journey, from first contact with the police to throughcare and liberation.
"This connection with a community of people who had similar experiences to mine provided non-judgemental support and hope and most importantly empowered me to make positive choices to focus on my recovery.
“I was fortunate to have support from my family and local recovery community from the time of my arrest, to prison then liberation but that is not everyone’s experience.
"The standards of care we are proposing today would ensure everyone with alcohol use disorder in our justice system is supported to find the recovery pathway that works for them.
"This will benefit the individual, their families and wider society as a whole.”
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