Expanding the reach of alcohol and other drug services: Prevalence and correlates of US adult engagement with online technology to address substance problems

Addict Behav. 2018 Dec;87:74-81. doi: 10.1016/j.addbeh.2018.06.018. Epub 2018 Jun 18.


Online technologies are well integrated into the day-to-day lives of individuals with alcohol and other drug (i.e., substance use) problems. Interventions that leverage online technologies have been shown to enhance outcomes for these individuals. To date, however, little is known about how those with substance use problems naturally engage with such platforms. In addition, the scientific literatures on health behavior change facilitated by technology and harms driven by technology engagement have developed largely independent of one another. In this secondary analysis of the National Recovery Study (NRS), which provides a geo-demographically representative sample of US adults who resolved a substance use problem, we examined a) the weighted prevalence estimate of individuals who engaged with online technologies to "cut down on substance use, abstain from substances, or strengthen one's recovery" (i.e., recovery-related use of online technology, or ROOT), b) clinical/recovery correlates of ROOT, controlling for demographic covariates, and c) the unique association between ROOT and self-reported history of internet addiction. Results showed one in ten (11%) NRS participants reported ROOT. Significant correlates included greater current psychological distress, younger age of first substance use, as well as history of anti-craving/anti-relapse medication, recovery support services, and drug court participation. Odds of lifetime internet addiction were 4 times greater for those with ROOT (vs. no ROOT). These data build on studies of technology-based interventions, highlighting the reach of ROOT, and therefore, the potential for a large, positive impact on substance-related harms in the US.

Keywords: Recovery; Smartphone applications; Social network sites; Technology; mHealth.

MeSH terms

  • Adult
  • Alcoholism / rehabilitation*
  • Delivery of Health Care*
  • Female
  • Humans
  • Internet / statistics & numerical data*
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Mobile Applications / statistics & numerical data
  • Online Social Networking
  • Patient Participation / statistics & numerical data*
  • Substance-Related Disorders / rehabilitation
  • Surveys and Questionnaires
  • Telemedicine / statistics & numerical data
  • United States