Online digital recovery support services: An overview of the science and their potential to help individuals with substance use disorder during COVID 19 and beyond
Background The COVID 19 pandemic and related social distancing public health recommendations will have indirect consequences for individuals with current and remitted substance use disorder (SUD) Not only will stressors increase risk for symptom exacerbation and/or relapse, but individuals will also have limited service access during this critical time. Individuals with SUD are using free, online digital recovery support services (D RSS) that leverage social engagement (i.e. social online D RSS) and simultaneously help these individuals to access support and adhere to public health guidelines. Barriers to SUD treatment and recovery support service access, however, are not unique to the COVID 19 epoch. The pandemic creates an opportunity to highlight problems that will persist beyond its immediate effects, and offer potential solutions that might help to address these long standing, systemic issues. To help providers and other key stakeholders effectively support those interested in, or who might benefit from, participation in free, social online D RSS, we review the expected therapeutic benefits and potential drawbacks of social online D RSS; we provide a typology to describe the array of services that a D RSS can provide; and we discuss a D RSS "case study" to illustrate how to apply the theory and typology, what is known empirically, and whether to refer and how to engage individuals with these online resources. Method Narrative review combining research and theory on both in person and online D RSS. Results Studies targeting in person recovery support services, such as AA and other mutual help groups, combined with theory about how social online D RSS might confer benefits, suggest these digital supports may engage individuals with SUD and mobilize salutary change in similar ways. While people may use in person and digital supports simultaneously, when comparing the two modalities, communication theory and telemedicine group therapy data suggest that D RSS may not provide the same magnitude of benefit as in person services. Research has not yet rigorously tested the effectiveness of social online D RSS specifically, though existing data suggest that those who use these services generally find their participation to be helpful. Content analyses suggest that these services are likely to facilitate social support and unlikely to expose individuals to harmful situations. Conclusions When in person treatment and recovery support services are limited, as is the case during the COVID 19 pandemic, expected therapeutic benefits and emerging data, taken together, suggest providers, mentors, and other community leaders may wish to refer individuals to social online D RSS. Given the array of available services with little existing data to guide specific recommendations, providers may rely upon the provided D RSS typology as well as trusted federal, academic, and national practice organization referral lists offered here when working with patients for whom D RSS may be appropriate.
Journal of Substance Abuse Treatment