How Alcohol Tags Can Shape Someone's Future

While the courts celebrate the high compliance rates, which free up time to deal with other cases, James experiences the realities of being ‘trapped’ by his sentencing requirements. However, Professor Sarah Byford from King's College London, a health economist who specialises in economic evaluation of disorders, including addiction, argues that the focus of offenders staying clean while wearing the tag is misplaced. “For me, alcohol dependence can have a huge negative impact on such a wide range of aspects of someone's life,” she explains. “But focusing only on the amount of alcohol you drink is really narrow.”

 

Byford’s most recent critique focuses on assertive outreach, a proactive, human-led clinical strategy designed to build a “therapeutic bond” between a carer and a patient. Unlike an alcohol tag, also known as a sobriety tag, which she describes as a “24/7 data stream", assertive outreach involves clinicians actively engaging with individuals in their own environments to foster trust and confidence. “Obviously [the tag] is not going to be the best way to build up trust.” She still believes that this could help people, but in the world of psychological therapy, it’s important to get to the underlying triggers for substance misuse because once the tag comes off, these issues remain unaddressed. “My biggest fear is that even if it works temporarily, when the tag comes off, everything might just go back to where they were before the tag went on. The tag is not resolving any of the very deep-seated issues that are causing the alcohol use disorder in the first place."

 

The root problem of alcohol tags lies in the difference between forced compliance and genuine rehabilitation. “It’s not somebody with a broken leg who's grateful for you to fix it. It’s somebody who’s fighting an urge to do what you don’t want them to do.” Sarah Byford’s approach is that if the ‘deep-rooted issues’ have not been resolved, it fails to effectively create lasting improvements. In line with the National Institute for Health and Care Excellence (NICE), if the quality-adjusted life year gains do not persist after the tag is removed, the initial cost of the device becomes difficult to justify.

 

The UK’s health system operates on a calculated threshold of £20,000 to £30,000 per quality-adjusted life year gained. This strict mathematical framework is designed to ensure that every pound spent on a disorder like alcohol dependence is a pound well invested.

 

Funding devices such as sobriety tags may appear cheaper within the criminal justice system, but this approach does not always prove cost-effective in the long run. Assertive outreach can deliver more lasting values. If the tech doesn’t rehabilitate someone once the tag comes off, it can become more expensive. “The idea that economics would encourage the use of cheap and easy alternatives is a complete myth. It’s just nonsense. Economics is not about saying which is the cheapest. It’s about saying, "Which is the best for the patients, for the resources we have available?” For a patient like James, who is commencing his life again, the real data is in the support that lets him reflect on his past.

 

If a tag provides “certainty and enforceability” for 120 days, why not 365 days? When asked about the future of this technology, she says, “If you want to keep tagging people forever, fine, but that is a human rights concern, an ethical nightmare that I would never feel comfortable with.”

 

For James, who’s an individual struggling with alcohol dependence, the alcohol tag is a mechanical solution to a psychological problem. Byford argues that while tags and medication can enforce sobriety, long-term recovery depends on “behavioural and psychological interventions”.

I spoke with a worker at the Likewise harm reduction facility to get an insight into harm reduction regarding what it is and how Likewise helps people with assertive outreach by helping people with their mental health, creating a community and creating a safe place to get support.

Clean Slate

The tension between the Ministry of Justice and health economists like Byford identifies a deeper conflict in the British identity. For decades, the legal system operated on a “tough on crime” mindset. Still, now society is changing, “We have moved so far in the other direction, and that to me just demonstrates the type of society we are, which is a society that has started to understand that these people are not criminals,” she says.

 

Byford remains honest about the limits of healthcare: "There's no kind of perfect intervention. She acknowledged that while assertive outreach is “essential”, it will not work for everyone the same way a tag may not work for everyone but work for others. Behavioural and psychological patterns fundamentally sustain alcohol dependency; the tag is merely a surface-level tool. “You can have the tag, you can have the medications,” she says, “but fundamentally, what they’re trying to get at is the psychological problems that have caused this.” Though the tag can nearly guarantee compliance, this is just a temporary fix for a lifelong crisis.

 

For James, the removal of the tag will be a moment of liberation but also a moment of vulnerability. He is hurt by the effect this had on his family; his eyes are watery at just the thought of his two children. “It’ll take time, but I want to rebuild my relationships. I just can’t believe it has taken me all these years to realise that I had a problem,” he says. “I want—I need to stay sober after this tag comes off, and slowly, with the help of therapy, I’m getting there.”

Turning 50 soon, he is no longer just a statistic, a “97% success rate”; he’s a father who has another chance to rebuild his life.

Please note that people can recover, and asking for help is a big step in the right direction

Available resources for support services: if you or anyone you know is currently in need of support, please don’t be afraid to call or ask for help.

Frank drugs helpline on 03001236600

  Likewise,  0114 3087000

Monday-Wednesday & Friday 9 am-5 pm; Thursday 9 am-7 pm

https://alcoholchange.org.uk/