Trying to curb alcohol use on your own with web-based or CD programs may not be very effective, a new study reports.
The study found these programs could reduce drinking slightly among adults and college students. But they appeared to be ineffective for reducing binge drinking and the negative social aspects linked with alcohol misuse.
The evidence, researchers said, shows that intense treatment may be needed to reduce drinking levels to recommended limits.
“At this point, the effects of the available brief electronic interventions are small, and evidence that they help people to drink within recommended limits is lacking,” said lead researcher Eric Dedert, an assistant professor of psychiatry and behavioral sciences from Duke University School of Medicine, in Durham, N.C.
“However, electronic interventions for alcohol misuse hold significant promise, and there is a need to develop more intensive interventions,” he said.
The report was published in the Aug. 4 Annals of Internal Medicine.
The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines say low-risk drinking for women means no more than three drinks in a single day, and no more than seven drinks in a week. For men, low-risk drinking means no more than four drinks in a single day and no more than 14 drinks a week.
To see if electronic programs were effective, Dedert and colleagues reviewed 28 previous studies.
The review included a range of electronic interventions. Interventions were delivered by CD-ROM, desktop computers in clinics, online delivery, mobile applications, or interactive voice response on the phone or computer, Dedert said.
“The most common electronic interventions in our review were brief, consisting of one-time interventions in which individuals would enter information about how much alcohol they drank, and then receive information on how their alcohol intake compared to their peer group,” he explained.
Other common treatment techniques were goal setting and providing information on the negative effects of drinking on physical health and overall functioning, Dedert said.
“Though human support for these electronic interventions was typically absent or limited, a minority of interventions was supplemented by 1.5 to 6.5 hours of support, including phone counseling. Electronic intervention also varied in duration, ranging from a single, two-minute interaction to as many as 62 interactions for more than a year,” he said.
Dedert added that some electronic interventions are freely available, including the “Rethinking Drinking” tool on the NIAAA website.
The researchers found that electronic interventions may work slightly to reduce alcohol consumption in the short term.
Specifically, for people using electronic interventions, there was evidence of reduced alcohol intake of an average of one less drink per week, with diminishing effects at 12 months. This was true of both college students and non-college adults, Dedert said.
There was little evidence that electronic interventions led to any significant long-term changes, the study found.
Few trials reported on other clinically significant outcomes, such as meeting drinking-limit guidelines, fewer binge-drinking episodes, reducing the social consequences of drinking, and cutting alcohol-related health problems.
“The available data provided insufficient evidence in support of a benefit of electronic interventions for these outcomes,” he said.
In addition, only a few trials have investigated electronic interventions for alcohol use disorders, which are a more severe form of alcohol misuse, Dedert said.
Dr. James Garbutt, a professor of psychiatry from the University of North Carolina, Chapel Hill, said, “The underlying idea is of interest — can we use brief and inexpensive electronic interventions to help individuals reduce their harmful drinking?”
But, “these data suggest that stronger electronic interventions, possibly including interventions from a live human being, may be necessary to attain more meaningful improvements in drinking behavior,” Garbutt said.