Making Inroads: Trial of An Online Early Intervention To Address Co-Occurring Anxiety And Alcohol Use Problems Among Young People

Abstract

Background/Aims: The transition to adulthood is a unique period characterised by numerous role changes and increased opportunities for alcohol consumption. Using alcohol to cope with anxiety symptoms is common, and young people with anxiety are at a greater risk of risky alcohol use and progression to alcohol use disorder. A randomised controlled trial was conducted to evaluate the efficacy of the Inroads program, an internet-delivered early intervention that targets anxiety, alcohol use, and the interconnections between these problems.

Method: Participants (aged 17-24; n=123) experiencing anxiety symptoms and harmful alcohol use were randomised to Inroads or a psychoeducation control. The Inroads intervention comprised 5 online CBT modules and weekly therapist support via email or phone. Primary outcomes assessed 2- and 6-months after baseline were standard drinks consumed in the past month, severity of alcohol-related consequences, and anxiety symptoms. Secondary outcomes were social anxiety and alcohol expectancies. Analyses were intention-to-treat using multi-level modeling for repeated measures.

Results: The Inroads program reduced anxiety and corrected alcohol expectancies relative to control. Alcohol consumption and related consequences reduced in both conditions; however, benefits were greater and sustained at 6 months for participants in the Inroads condition.

Conclusion: The study is the first to evaluate the benefits of early intervention to interrupt the trajectory to co-occurring anxiety and alcohol use disorders. The online format combined with therapist support is aligned with youth treatment preferences, and has the potential for wide dissemination to reach those who are not able or willing to access face-to-face treatment.