Schaub MP, Castro RP, Wenger A, et al. (2019). Web-based self-help with and without chat counseling to reduce cocaine use in cocaine misusers: Results of a three-arm randomized controlled trial. Internet Interventions. 17. doi: 10.1016/j.invent.2019.100251
Researchers recruited 311 individuals who had used cocaine at least twice in the last 30 days and randomized them to receive a 6-week, web-based, self-help intervention with chat counseling (SC+) or alone (SC) or to a wait-list control group (control). The intervention (Snow Control 2.0) was a 9-module CBT-based intervention for cocaine use with a web-based consumption and goal diary and personalized feedback. SC+ participants could initiate up to 3 30-minute motivational enhancement-based chat sessions with trained therapists. Participants completed assessments of cocaine use (frequency and quantity), severity of cocaine dependence, substance use history, and mental health at baseline and 6 weeks (post-intervention) and 6 months post-baseline. Study retention was low at 6 weeks (n=44) and 6 months (n=47). Significant improvements were observed in quantity (SC+, SC, control) and frequency (SC+, SC) of cocaine use, cocaine dependence (SC+, SC), overall alcohol use (SC+, SC, control), risky alcohol use (SC+, SC), and mental health (SC+) between baseline and follow-up assessments. Both intervention groups reduced risky alcohol use significantly more than the control. SC+ participants reduced cocaine use frequency significantly more than those in the control group. SC participants reduced overall alcohol use significantly more than SC+ and control participants. SC participants had greater treatment retention (module completion, daily diary entries) than SC+ participants. Less frequent cocaine use was related to greater intervention module completion. SC+ and SC participants did not differ in intervention satisfaction. Results did not demonstrate an advantage to adding chat counseling to Snow Control 2.0. Given retention issues in the current study, researchers conclude that future research should explore different methods of evaluating digital interventions for cocaine use.