A Web-Based Intervention for Users of Amphetamine-Type Stimulants: 3-Month Outcomes of a Randomized Controlled Trial

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Abstract

Background

Among illicit drugs, the prevalence of amphetamine-type stimulant (ATS) use is second only to cannabis. Currently, there are no approved pharmacotherapies for ATS problems, but some face-to-face psychotherapies are effective. Web-based interventions have proven to be effective for some substance use problems, but none has specifically targeted ATS users.

Objective

The objective of the study was to evaluate the effectiveness of a Web-based intervention for ATS problems on a free-to-access site compared with a waitlist control group.

Methods

We used a randomized controlled trial design. The primary outcome measure was self-reported ATS use in the past three months assessed using the Alcohol, Smoking, Substance Involvement Screening Test (ASSIST). Other measures included quality of life (EUROHIS score), psychological distress (K-10 score), days out of role, poly-drug use, general help-seeking intentions, actual help-seeking, and “readiness to change”. The intervention consisted of three fully automated, self-guided modules based on cognitive behavioral therapy and motivation enhancement. The analysis was an intention-to-treat analysis using generalized estimating equation models, with a group by time interaction as the critical assessment.

Results

We randomized 160 people (intervention n=81, control n=79). At three months, 35/81 (43%) intervention and 45/79 (57%) control participants provided follow-up data. In the intervention group, 51/81 (63%) completed at least one module. The only significant group by time interaction was for days out of role. The pre/post change effect sizes showed small changes (range d=0.14 to 0.40) favoring the intervention group for poly-drug use, distress, actual help-seeking, and days out of role. In contrast, the control group was favored by reductions in ATS use, improvements in quality of life, and increases in help-seeking intentions (range d=0.09 to 0.16).

Conclusions

This Web-based intervention for ATS use produced few significant changes in outcome measures. There were moderate, but nonsignificant reductions in poly-drug use, distress, days partially out of role, and increases in help-seeking. However, high levels of participant attrition, plus low levels of engagement with the modules, preclude firm conclusions being drawn on the efficacy of the intervention and emphasize the problems of engaging this group of clients in a fully automated program.

Trial Registration

Australian and New Zealand Clinical Trials Registry: ACTRN 12611000947909; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000947909 (Archived by WebCite at http://www.webcitation.org/6SHTxEnzP).

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Author and article information

Contributors

Robert J Tait:

National Drug Research InstituteFaculty of Health SciencesCurtin UniversityGPO Box U1987Perth, 6845Australia61 8 9266161061 8 92661611robert.tait@curtin.edu.au

ORCID: http://orcid.org/0000-0003-0648-3093

Journal

Journal ID (nlm-ta): JMIR Ment Health

Journal ID (iso-abbrev): JMIR Ment Health

Journal ID (publisher-id): JMH

Title: JMIR Mental Health

Publisher: JMIR Publications Inc. (Toronto, Canada )

ISSN (Electronic): 2368-7959

Publication date Collection: Jul-Dec 2014

Publication date (Electronic): 11 September 2014

Volume: 1

Issue: 1

Electronic Location Identifier: e1

Affiliations

[1] ¹National Drug Research Institute Faculty of Health Sciences Curtin University PerthAustralia

[2] ²National Institute for Mental Health Research The Australian National University CanberraAustralia

[3] ³Centre for Research on Ageing, Health and Wellbeing The Australian National University CanberraAustralia

[4] ⁴National Drug and Alcohol Research Centre University of New South Wales SydneyAustralia

[5] ⁵Centre for Translational Neuroscience and Mental Health University of Newcastle NewcastleAustralia

[6] ⁶Black Dog Institute University of New South Wales and Prince of Wales Hospital SydneyAustralia

Author notes

Corresponding Author: Robert J Tait robert.tait@ 123456curtin.edu.au

Author information

Robert J Tait http://orcid.org/0000-0003-0648-3093

Rebecca McKetin http://orcid.org/0000-0003-2833-4830

Frances Kay-Lambkin http://orcid.org/0000-0002-4252-5572

Bradley Carron-Arthur http://orcid.org/0000-0001-6853-7902

Anthony Bennett http://orcid.org/0000-0002-0399-4798

Kylie Bennett http://orcid.org/0000-0003-4160-492X

Helen Christensen http://orcid.org/0000-0003-0435-2065

Kathleen M Griffiths http://orcid.org/0000-0003-1556-0708

Article

Publisher ID: v1i1e1

DOI: 10.2196/mental.3278

PMC ID: 4607377

PubMed ID: 26543901

SO-VID: ffe08452-3f8c-4172-8a6c-de0ae026ac9d

Copyright © ©Robert J Tait, Rebecca McKetin, Frances Kay-Lambkin, Bradley Carron-Arthur, Anthony Bennett, Kylie Bennett, Helen Christensen, Kathleen M Griffiths. Originally published in JMIR Mental Health (http://mental.jmir.org), 11.09.2014.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 29 January 2014

Date revision requested : 27 April 2014

Date revision received : 11 May 2014

Date accepted : 06 August 2014

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