24/7 Sobriety programs largely focus on reducing alcohol consumption among justice-involved individuals whose alcohol use has led them to repeatedly threaten public safety. Participants are ordered to abstain from alcohol use and subject to frequent alcohol testing (e.g., twice daily breathalyzers, remote alcohol monitoring); those testing positive face an immediate sanction, typically a night or two in jail. Unlike drug courts and other forms of coerced substance use disorder treatment, 24/7 does not require participants to enter a treatment program or attend self-help group meetings; however, these approaches are not necessarily mutually exclusive. The empirical evidence suggests that participants largely abstain from heavy drinking while in the program and that 24/7 participation is associated with lower probability of criminal legal involvement and mortality. This evidence is largely based on research in the Great Plains states with large rural populations. Several questions remain about these programs (e.g., optimal program length, possible benefits of incorporating positive incentives, efficacy of different alcohol testing technologies), many of which can best be answered in an experimental setting. In addition to reviewing the existing research on 24/7, this paper highlights additional research questions and ideas for conducting randomized controlled trials with the program, especially in more urban areas.

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