JMIR Publications

ABSTRACT

Background:

Drug misuse is complex, and various treatment modalities are emerging. Mental health conditions like anxiety and depression, which co-exist with substance use are often undiagnosed and undertreated. Providing supportive text messages to individuals with substance use disorder offers the prospect of managing and improving symptoms of drug misuse and associated comorbidities.

Objective:

This study aimed to evaluate the impact of the daily supportive text message program (Text4Hope-Addiction Support) in mitigating cravings and mental health symptoms in subscribers and to quantify user satisfaction with the Text4Hope-Addiction Support program.

Methods:

Subscribers to the Text4Hope-Addiction Support program received daily supportive text messages crafted based on addiction counselling and cognitive behavioral therapy principles for three months. Participants completed an anonymous online questionnaire to assess cravings, anxiety, and depressive symptoms using the Brief Substance Craving Scale, Generalized Anxiety Disorder-7 Scale, and Patient Health Questionnaire-9 Scale at enrollment (baseline), after six weeks and three months. Likert scale satisfaction responses were used to assess various aspects of the Text4Hope-Addiction program.

Results:

There were significant differences between mean baseline and three-month BSCS scores ( -2.17, 95% CI of -0.62 to -3.72), PHQ-9 scores (-5.08, 95% CI of -1.65 to -8.51), and the GAD-7 scores (-2.93, 95% CI of -0.48 to -5.56). Participants who received the supportive text messages reported a reduced desire to use drugs, a long time before usage (reduced craving frequency) reflected in respective changes from a baseline score of 41.1% and 32.5%. About 89% of participants agreed that supportive text messages (Text4Hope-Addiction) helped them cope with addiction-related stress; 81% reported that messages assisted them in coping with anxiety. Overall, 69% agreed it helped them cope with depression related to addiction, 85% felt connected to a support system, 77% were hopeful of the ability to manage addiction issues, and 73% felt their overall mental wellbeing was improved. Most participants agreed that the interventions were positive, affirmative, and succinct. Furthermore, 88% always read the messages, 83% took positive or beneficial action after reading and no participant took a negative action after reading the messages. Also, most of the participants agreed to recommend other diverse technology-based services as adjunctive treatment for their mental and physical health.

Conclusions:

Subscribers of Text4Hope addiction support experienced an improvement in both mental health and addiction symptoms. Addiction care practitioners and policymakers could implement supportive text-based strategies to complement conventional treatments for addiction, given that mobile devices are widely used.