Establishing an Online Intervention Targeting Episodic Future Thinking in Substance Users

Individuals with substance use disorders tend to overvalue more immediate, smaller rewards such as the reinforcing effects of a substance, while devaluing more distant rewards such as future health and career goals. This pattern of impulsive decision-making, termed delay discounting, is associated with multiple risky health-related behaviors and poorer outcomes for those in treatment for substance use disorders. Decreasing discounting of delayed rewards may be an important target for decreasing substance use and improving treatment outcomes.

One approach for decreasing discounting of delayed rewards is to increase future prospection using a procedure known as episodic future thinking (EFT). EFT, a component of episodic memory, is the process of thinking about and recording specific personal events that may occur in the future. EFT is thought to improve discounting by increasing the salience of, attention to, and contemplation of one’s future while making choices. EFT has been evaluated previously in the context of studying obesity and eating behavior and is associated with decreased discounting and caloric intake in single-session laboratory studies. These findings have fostered interest in using EFT as a clinical intervention in vulnerable populations to modify unhealthy or risky behavioral choices that correlate with higher discounting rates, including problematic substance use.

The overarching goal of this line of research is to develop an online EFT intervention that can be included as a component in substance use prevention or intervention packages. The aims of this pilot proposal are to a) develop a platform for online delivery of an EFT intervention targeting cannabis users, and b) conduct a pilot study to determine if EFT delivered online in a sample of heavy cannabis users improves delay discounting and decreases demand for cannabis. Results form this project will provide initial data on the efficacy of online delivered EFT in a sample of heavy cannabis users, which will support further development of EFT as a clinical tool to improve the effectiveness of existing behavioral interventions for substance use disorders.