The use of digital technology in substance misuse recovery


Alongside recent trends in the purchasing of illicit substances online, there has been a growth in the availability of online resources dedicated to treatment and recovery from substance misuse, including online interventions, mutual-aid groups and forums. Currently however, there is a lack of research on the utilisation of these online resources. Therefore, the aim of this study was to examine the use of these online resources by employing online data collection techniques. A quantitative online survey was used to investigate the range of online recovery resources used, and to compare the types of resources used at different stages of the substance misuse recovery journey. Qualitative online interviews were also conducted to investigate how individuals use these online resources alongside traditional offline recovery resources. Analyses revealed that forums were the most widely accessed online resource, however participants who were currently working towards abstinence were more likely to use therapeutic resources that explore the underlying causes behind substance misuse and help to manage these difficulties. Qualitative findings suggested an interaction between online and offline recovery resources. For example, participants reported that online resources may provide initial contact information for offline recovery meetings, or that offline support with developing digital skills may facilitate access to online resources. Despite these apparent benefits, there is limited signposting advice to direct people to appropriate online treatment and recovery resources for their substance misuse, so it is hoped that the findings from this study will help to inform future research around the production of such signposting advice.

Substance misuse; online resources; mixed-methods
Author biographies

Stephanie Dugdale

Stephanie Dugdale is Research Associate at Breaking Free Group, and her current role focuses on expanding the evidence base for Breaking Free Online. She has a background in Health Psychology and is currently studying for a Professional Doctorate in Health Psychology at Staffordshire University, UK.

Sarah Elison

Sarah Elison is a Chartered Psychologist and Research Director at Breaking Free Group, where she leads the ongoing programme of research into the efficacy of Breaking Free Online. She has a background in behavioural science research and an interest in evaluating complex behavioural change interventions.

Glyn Davies

Glyn Davies is Service Development Director at Breaking Free Group. He played an instrumental role in the development of Breaking Free Online. He has an academic background in criminology and criminal justice, and previous experience of the commissioning and delivery of substance misuse and criminal justice services.

Jonathan Ward

Jonathan Ward is the Founder and Managing Director of Breaking Free Group. He led the team that developed Breaking Free Online. Previously he practiced as a Clinical Psychologist in the U.K. National Health Service, working primarily in adult mental health.

Michaela Jones

Michaela Jones is in long term recovery and has been active in promoting visible recovery since 2008. As a “recoverist” she is engaged in a variety of roles, with a focus on building sustainable recovery communities.

Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: A meta-analysis. PloS one, 5(10), e13196.

Barratt, M. J. (2012). The efficacy of interviewing young drug users through online chat. Drug and Alcohol Review, 31, 566-572.

Barratt, M. J., & Lenton, S. (2010). Beyond recruitment? Participatory online research with people who use drugs. International Journal of Internet Research Ethics, 3, 69-86.

Best, D., & Laudet, A. (2010). The potential of recovery capital. London, UK: RSA.

Best, D., McKitterick, T., Beswick, T., & Savic, M. (2015). Recovery capital and social networks among people in treatment and among those in recovery in York, England. Alcoholism Treatment Quarterly, 33, 270-282.

Borkman, T. (2008). The twelve-step recovery model of AA: A voluntary mutual help association. In L. A. Kaskutas & M. Galanter (Eds.), Recent developments in alcoholism (pp. 9-35). New York, NY: Springer.

British Psychological Society. (2013). Ethics guidelines for internet-mediated research. Leicester, UK: Author.

Carbonari, J. P., & DiClemente, C. C. (2000). Using transtheoretical model profiles to differentiate levels of alcohol abstinence success. Journal of Consulting and Clinical Psychology, 68, 810-817.

Carroll, K., Ball, S., Martino, S., Nich, C., Babuscio, T., Nuro, K., . . . Rounsaville, B. (2008). Computer-assisted delivery of cognitive-behavioral therapy for addiction: A randomized trial of CBT4CBT. American Journal of Psychiatry, 165, 881-888.

Carroll, K., Ball, S., Martino, S., Nich, C., Babuscio, T., & Rounsaville, B. (2009). Enduring effects of a computer-assisted training program for cognitive behavioral therapy: A 6-month follow-up of CBT4CBT. Drug and Alcohol Dependence, 100, 178-181.

Carroll, K. M., Kiluk, B. D., Nich, C., Gordon, M. A., Portnoy, G. A., Marino, D. R., & Ball, S. A. (2014). Computer-assisted delivery of cognitive-behavioral therapy: Efficacy and durability of CBT4CBT among cocaine-dependent individuals maintained on methadone. Computer, 171, 436-444.

Carroll, K. M., & Rounsaville, B. J. (2010). Computer-assisted therapy in psychiatry: Be brave—it’s a new world. Current Psychiatry Reports, 12, 426-432.

Cloud, W., & Granfield, R. (2008). Conceptualizing recovery capital: Expansion of a theoretical construct. Substance Use & Misuse, 43, 1971-1986.

Connors, G. J., DiClemente, C. C., Velasquez, M. M., & Donovan, D. M. (2012). Substance abuse treatment and the stages of change: Selecting and planning interventions. New York, NY: Guilford Press.

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: Sage Publications.

DiClemente, C. C., Nidecker, M., & Bellack, A. S. (2008). Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. Journal of Substance Abuse Treatment, 34, 25-35.

DiClemente, C. C., Schlundt, D., & Gemmell, L. (2004). Readiness and stages of change in addiction treatment. American Journal on Addictions, 13, 103-119.

Dugdale, S., Elison, S., Davies, G., Ward, J., & Dalton, M. (2016). A qualitative study investigating the continued adoption of Breaking Free Online across a national substance misuse organisation: Theoretical conceptualisation of staff perceptions. The Journal of Behavioral Health Services and Research. Advanced online publication.

Easton, S. (2014). CLIF impact project: Community learning and digital inclusion. National Institute of Adult Continuing Education.

Edmondson, A. C., Bohmer, R. M., & Pisano, G. P. (2001). Disrupted routines: Team learning and new technology implementation in hospitals. Administrative Science Quarterly, 46, 685-716.

Elison, S., Davies, G., & Ward, J. (2015a). An outcomes evaluation of computerised treatment for problem drinking using Breaking Free Online Alcoholism Treatment Quarterly, 33, 185-196.

Elison, S., Davies, G., & Ward, J. (2015b). Sub-group analyses of a heterogeneous sample of service users accessing computer-assisted therapy (CAT) for substance dependence using Breaking Free Online. Journal of Medical Internet Research, 2(2), e13.

Elison, S., Humphreys, L., Ward, J., & Davies, G. (2013). A pilot outcomes evaluation for computer assisted therapy for substance misuse- An evaluation of Breaking Free Online. Journal of Substance Use, 19, 313-318.

Elison, S., Ward, J., Davies, G., Lidbetter, N., Dagley, M., & Hulme, D. (2014). An outcomes study of eTherapy for dual diagnosis using Breaking Free Online. Advances in Dual Diagnosis, 7, 52-62.

Ess, C., & Association of Internet Researchers. (2002). Ethical decision-making and Internet research: Recommendations from the AoIR ethics working committee. Retrieved from

Fitzgerald, A. (2013, November). Social connectedness and recovery: Do different types of social connectedness affect substance use disorders recovery outcomes among consumers receiving services in a recovery-oriented system of care approach in a community-based, urban setting? Paper presented at the 141st APHA Annual Meeting, Boston, MA, USA.

Gainsbury, S., & Blaszczynski, A. (2011). Online self-guided interventions for the treatment of problem gambling. International Gambling Studies, 11, 289-308.

Goodyer, P. (2014). Staying clean: Why social networks matter. Of Substance: The National Magazine on Alcohol, Tobacco and Other Drugs, 12(3), 14-17.

Gruber, T., Szmigin, I., Reppel, A. E., & Voss, R. (2008). Designing and conducting online interviews to investigate interesting consumer phenomena. Qualitative Market Research: An International Journal, 11, 256-274.

Helsper, E. (2008). Digital inclusion: an analysis of social disadvantage and the information society. (1409806146). London, UK.

Hester, R. K., Lenberg, K. L., Campbell, W., & Delaney, H. D. (2013). Overcoming Addictions, a Web-based application, and SMART Recovery, an online and in-person mutual help group for problem drinkers, part 1: Three-month outcomes of a randomized controlled trial. Journal of Medical Internet Research, 15(7), e134.

Hewson, C. (2007). Gathering data on the Internet: Qualitative approaches and possibilities for mixed methods research. In A. N. Joinson, K. McKenna, T. Postmes, & U.-D. Reips (Eds.), Oxford handbook of internet psychology (pp. 405-428). UK: Oxford University Press.

Hwang, J., & Christensen, C. M. (2008). Disruptive innovation in health care delivery: A framework for business-model innovation. Health Affairs, 27, 1329-1335.

Joinson, A. N. (2001). Self-disclosure in computer-mediated communication: The role of self-awareness and visual anonymity. European Journal of Social Psychology, 31, 177-192.

Kaskutas, L. A., Borkman, T. J., Laudet, A., Ritter, L. A., Witbrodt, J., Subbaraman, M. S., . . . Bond, J. (2014). Elements that define recovery: the experiential perspective. Journal of Studies on Alcohol and Drugs, 75, 999-1010.

Kay-Lambkin, F., Baker, A., Lewin, T., & Carr, V. (2011). Acceptability of a clinician-assisted computerized psychological intervention for comorbid mental health and substance use problems: Treatment adherence data from a randomized controlled trial. Journal of Medical Internet Research, 13(1), 254-264.

Kay-Lambkin, F. J., Baker, A. L., Kelly, B. J., & Lewin, T. J. (2012). It's worth a try: The treatment experiences of rural and urban participants in a randomized controlled trial of computerized psychological treatment for comorbid depression and alcohol/other drug use. Journal of Dual Diagnosis, 8, 262-276.

Kay-Lambkin, F. J., Baker, A. L., Lewin, T. J., & Carr, V. J. (2009). Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: A randomized controlled trial of clinical efficacy. Addiction, 104, 378-388.

MacLean, D., Gupta, S., Lembke, A., Manning, C., & Heer, J. (2015). Forum77: An analysis of an online health forum dedicated to addiction recovery. In Proceedings of the 18th ACM Conference on Computer Supported Cooperative Work & Social Computing (pp. 1511-1526). New York, NY, USA: ACM.

Månsson, J., & Ekendahl, M. (2013). Legitimacy through scaremongering: The discursive role of alcohol in online discussions of cannabis use and policy. Addiction Research & Theory, 21, 469-478.

Migneault, J. P., Migneault, J. P., Adams, T. B., Migneault, J. P., Adams, T. B., Read, J. P., . . . Read, J. P. (2005). Application of the Transtheoretical Model to substance abuse: Historical development and future directions. Drug and Alcohol Review, 24, 437-448.

Morley, K. I., Lynskey, M. T., Moran, P., Borschmann, R., & Winstock, A. R. (2015). Polysubstance use, mental health and high‐risk behaviours: Results from the 2012 Global Drug Survey. Drug and Alcohol Review, 34, 427-437.

Neale, J., Allen, D., & Coombes, L. (2005). Qualitative research methods within the addictions. Addiction, 100, 1584-1593.

Orsolini, L., Francesconi, G., Papanti, D., Giorgetti, A., & Schifano, F. (2015). Profiling online recreational/prescription drugs' customers and overview of drug vending virtual marketplaces. Human Psychopharmacology: Clinical and Experimental, 30, 302-318.

Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research & Practice, 19, 276-288.

Sheehan, K. B. (2001). E‐mail survey response rates: A review. Journal of Computer‐Mediated Communication, 6(2).

Warschauer, M. (2004). Technology and social inclusion: Rethinking the digital divide. Cambridge, MA: MIT Press.

Weaver, T., Madden, P., Charles, V., Stimson, G., Renton, A., Tyrer, P., . . . Wright, N. (2003). Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. The British Journal of Psychiatry, 183, 304-313.

Williams, A. L., & Merten, M. J. (2008). A review of online social networking profiles by adolescents: Implications for future research and intervention. Adolescence, 43, 253-274.

Wright, K. B. (2005). Researching Internet‐based populations: Advantages and disadvantages of online survey research, online questionnaire authoring software packages, and web survey services. Journal of Computer‐Mediated Communication, 10(3).

Yarosh, S. (2013). Shifting dynamics or breaking sacred traditions? The role of technology in twelve-step fellowships. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (pp. 3413-3422). New York, NY, USA: ACM.





PDF views