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Sunday, May 11, 2008

It worked like a charm: Alcohol monitor ankle bracelets

Dr. Howard Markel's story:
Like most patients assigned to my substance abuse clinic these days, John, a stylish 22-year-old cosmetology student, did not arrive voluntarily.

John had had two drunken driving violations, one in which another driver was injured. A judge had ordered John to attend my weekly recovery group for young adults facing legal trouble. The judge had also ordered him to obtain and wear a boxy plastic ankle bracelet – a SCRAM – Secure Continuous Remote Alcohol Monitor.

The SCRAM records his alcohol intake by measuring air and perspiration emissions from the skin every hour. Once a day, John goes to a modem so it can transit data from the last 24 hours to a monitoring agency and his probation officer. "SCRAM keeps me from even thinking about drinking," John said.

Last year, American judges ordered SCRAM devices for thousands of defendants released on bond and awaiting trial for alcohol-related offenses, those sentenced on probation, and under-age drinkers.

Yet the device is not perfect. When John was chosen by a favorite instructor to work on a fashion show at the airport, he worried about how to inform her before security personnel discovered it. I urged him to be honest, and fortunately the teacher proved to be entirely supportive. She suggested letting the others in their group pass through security first and a little later, explaining the situation to the inspectors. "It worked like a charm," John told me the next week.

John is beginning to understand the severity of his alcohol addiction and how it threatens his life and well-being. Over the past five months, he has remained sober and has made significant progress.

One could argue that SCRAM and the threat of jail bought those five months of sobriety and treatment for John. As a physician, I remain uncomfortable aiding and abetting coercive methods like SCRAM. But this concern is overshadowed by a far greater one surrounding his long-term health. Soon John will "graduate" from his court-supervised treatment. His real test of recovery begins the day his SCRAM device is removed from his ankle.

Advice to families of problem drinkers: If your drinker has been involved with the criminal justice system, consider asking law enforcement officials about SCRAM.

Read another recovery story.

Thanks to Dr. Howard Markel for the source article in the May 6 issue of the NY Times.

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