Abstract
Background: The COVID-19 pandemic disrupted access to treatment for substance use disorders (SUDs), while alcohol and cannabis retail sales increased. During the pandemic, we tested a tailored digital health solution, Woebot-SUDs (W-SUDs), for reducing substance misuse.
Methods: In a randomized controlled trial, we compared W-SUDs for 8 weeks to a waitlist control. U.S. adults (N = 180) who screened positive for substance misuse (CAGE-AID>1) were enrolled June-August 2020. The primary outcome was the change in past-month substance use occasions from baseline to end-of-treatment (EOT). Study retention was 84%. General linear models tested group differences in baseline-to-EOT change scores, adjusting for baseline differences and attrition.
Results: At baseline, the sample (age M = 40, SD = 12, 65% female, 68% non-Hispanic white) averaged 30.2 (SD = 18.6) substance occasions in the past month. Most (77%) reported alcohol problems, 28% cannabis, and 45% multiple substances; 46% reported moderate-to-severe depressive symptoms. Treatment participants averaged 920 in-app text messages (SD = 892, Median = 701); 96% of completed lessons were rated positively; and 88% would recommend W-SUDs. Relative to waitlist, W-SUDs participants significantly reduced past-month substance use occasions (M = -9.1, SE = 2.0 vs. M = -3.3, SE = 1.8; p = .039). Secondary substance use and mood outcomes did not change significantly by group; however, reductions in substance use occasions correlated significantly with increased confidence and fewer substance use problems, cravings, depression and anxiety symptoms, and pandemic-related mental health effects (p-value<.05).
Conclusions: W-SUDs was associated with significant reductions in substance use occasions. Reduction in substance use occasions was associated with better outcomes, including improved mental health. W-SUDs satisfaction was high.
Keywords: Artificial intelligence; COVID-19 pandemic; Randomized controlled trial; Relational conversational agent; Substance-related disorders.
【저자키워드】 Randomized controlled trial, COVID-19 pandemic, artificial intelligence, substance-related disorders, Relational conversational agent, 【초록키워드】 COVID-19, Treatment, pandemic, Depression, mental health, Substance use disorder, Substance use, outcome, alcohol, outcomes, Depressive symptoms, Health, artificial, female, age, Satisfaction, attrition, general linear model, anxiety symptoms, Primary outcome, disorders, problems, participant, relative, positive, MOST, Effect, secondary, enrolled, tested, significantly, reported, reduced, screened, reducing, correlated, reductions in, averaged, baseline, 【제목키워드】 therapeutic, reducing,