A new systematic review and meta-analysis coming out of the National Institute for Health and Care Research (NIHR) in the U.K. shows a dramatic reduction in relapse rates using remote interventions such as smartphone apps in the treatment of substance use disorders.

The meta-analysis of 29 databases yielded 34 randomized, controlled trials involving 6,461 participants and 42 different remote interventions. Patients were receiving treatment for alcohol use disorder (AUD) or substance use disorder (SUD) or both. Substances included opioids and stimulants. 

Remote interventions were grouped into four different types:

• Remote recovery support: A range of interventions to check up on recovery progress, maintain or improve motivation, support recovery goals, identify risks of or actual relapse, and/or facilitate access to treatment or other recovery services if required.

• Remote talking therapy: Remote, synchronous group or individual counseling sessions, typically based on cognitive, behavioral, psychological, psychodynamic, or 12-step interventions and delivered by a trained, qualified therapist or counselor.

• Self-guided therapy: A structured program containing different activities that people work through themselves, such as self-monitoring and skill development.

• Other therapies: One involved a game, and another one was a hybrid recovery/talk therapy app.

All interventions were compared against “treatment as usual.” The top line results are somewhat amazing. “When remote interventions supplemented in-person care, there was a 39% lower odds of relapse,” researchers found, “and a reduction in the mean days of use.” The numbers were even better when remote therapy either partially or completely replaced in-person therapy. In that case, there was a 49% reduction in the likelihood of relapse.

Researchers added a big caveat to those numbers: “High risk-of-bias means findings should be interpreted with caution.” The main risk of bias here is that abstinence is largely self-reported. However, that is true for both the treatment as usual results, and the remote treatment results.

The journal, Addiction, published the study on March 24, 2025. Medscape News U.K. reviewed the research and concluded that, even with the bias, remote intervention “does not appear to lead to worse outcomes.” That means it leads to better outcomes, even if it completely replaces in-person interventions. That is a stunning development. The NIHR report concludes:

There was a reduction in days of alcohol/drug use in people who received remote interventions as a replacement or partial replacement for in-person treatment when compared with exclusively in-person treatment.

The researchers then attempted to explain why replacing in-person interventions with remote interventions results in a lower relapse rate. Among the factors they cite:

• improved access to support
• convenience of accessing support
• “opportunities for self-management”
• more interactive care between patient and providers
• eliminating geographical barriers to support
• reducing social barriers/stigma of receiving support

What these results appear to indicate is that you can achieve recovery from AUD or SUD, after initial diagnosis and standard treatment, through the independent use of a recovery app. If you are currently in treatment, your outcome will likely improve if you start using a recovery app. Even if you prefer in-person treatment, your outcome will likely improve if you also use a recovery app.

The results may indicate that entirely replacing in-person therapy with remote therapy for persons in recovery from AUD and SUD will lead to improved outcomes. That could lead to a dramatic change in the way society diagnoses and treats substance use disorders.

Written by Steve O’Keefe. First published April 9, 2025.

Sources:

“How effective are remote and/or digital interventions as part of alcohol and drug treatment and recovery support? A systematic review and meta-analysis,” Addiction, March 24, 2025.

“Remote Support Cut Risk for Relapse in Addiction Treatment,” Medscape News U.K., April 04, 2025.

Image courtesy of Wikimedia Commons.