TeleHealth Resources for IndiVidualizEd Goals (THRIVE) in Alcohol Recovery Study: Initial Findings

Background: Alcohol use disorder (AUD) is prevalent and costly, and associated with significant morbidity and mortality. Effective pharmacological and psychosocial treatments for AUD exist, although many individuals do not receive medications and most are treated via mutual support group participation. Alcoholics Anonymous and other mutual support programs have been shown to be highly effective in supporting abstinence, and they are a tremendously valuable option for those interested in abstinence-based recovery. Yet, approximately 80% of individuals with AUD never seek treatment and not wanting to stop drinking is a common barrier to seeking treatment. AA and other mutual support programs are often abstinence-based, yet programs that focus on reductions in drinking have been shown to be as effective at reducing harms related to alcohol use. One program that has considerable promise for promoting AUD recovery is mindfulness-based relapse prevention (MBRP). Efficacy of MBRP for reducing heavy drinking has been shown in several trials. Further, MBRP explicitly targets neurobiologically-informed domains of addiction: inhibitory control over behavioral responses (executive function); craving and cue reactivity (incentive salience); and negative affect (negative emotionality). MBRP may also be more effective than existing continuing care options in targeting broader health and life functioning. MBRP also has the potential to be broadly accessible via video conferencing. Methods: The goal of this study is to examine the effectiveness of MBRP groups delivered via video conferencing in promoting whole-person recovery from AUD following an attempt to change or stop drinking via treatment or self-change, as compared to referral to online mutual support groups. This study will also examine how MBRP affects mechanisms of behavior change based on neurobiologically-informed addiction cycle domains. Results: Participants from across the United States (n=50; 56% female; 70.6% white, 19.6% Black/African American, 5.9% American Indian or Alaska Native, 2.0% Asian; 13.7% Hispanic) were recruited via web-based and social media advertisements. Approximately 75% of participants were interested in drinking reduction goals and all met criteria for AUD with an average of 6.9 symptoms of AUD. Conclusions: Longitudinal follow-ups are ongoing and a one year follow-up will be completed in November 2024. We hypothesize MBRP will be associated with significant drinking reductions, and significantly greater remission from AUD than referral to mutual support.