Internet-based interventions — messages that click Dr. Peter Tossmann delphi-Gesellschaft für Forschung, Beratung und Projektentwicklung mbH, Berlin EMCDDA Conference Identifying Europe’s information needs for effective drug policy Lisbon, 6–8 May 2009

Initial situation EIAA Mediascope Europe, Million people in Europe have access to the internet 55% of all internet users in Europe are online daily 42% of all internet users in Europe are looking for health information via the internet

Internet and health communication  Informational websites  Forums for discussion and self help / blogs  Interactive tests  Counselling via Chat,  Structured intervention programmes

The objective of this review is to give an overview of existing internet- based drug treatment interventions in the EU Member States and to describe examples of good practice EMCDDA-Study (2008): Review on Internet-based drug treatment interventions

..... a specifically elaborated or adapted, structured and scheduled drug treatment intervention, offered on and communicated over the World Wide Web. What is an “Internet-based drug treatment intervention” ? Definition:

Methods Survey within the Reitox network 30 National Focal Points: Are you aware of internet-based drug treatment interventions in your country Literature investigation Search-terms: ‘internet-based’, ‘web-based’, ‘treatment’, ‘programme’, ‘drug’, ‘cocaine’, ‘cannabis ’

Internet-based drug treatment intervention in EU member states: Four programmes focusing cannabis users Results Live Onlinebehandeling Cannabis

Initiation Date: Dec 2004 Type of programme: free self-help programme Recommended/Scheduled duration of the intervention: Weeks

Programme elements:  craving and smoking diary  tailored feedback  relapse prevention („emergency plan“)  information Evaluation: yearvisitorsusers signed inusers competed ,4641, (8.8%) ,8011, (8.9%)

Live Onlinebehandeling Cannabis Initiation Date: May 2008 Type of programme: Recommended/Scheduled duration of the intervention: 10 Weeks fee-based programme including scheduled contact with counsellor

Live Onlinebehandeling Cannabis  identification of personal risk situations  forum  personal goal setting  tailored feedback  smoking and craving diary  exercise: how to cope with craving and peer pressure? Programme elements:

Initiation Date: Jan 2008 Type of programme: fee-based programme including scheduled contact with counsellor Recommended/Scheduled duration of the intervention: 3 month

Programme elements:  craving diary  Pros & Cons Balance  risk analysis  development of a personal treatment plan  working with risk situation  emergency plan From January 2008 until May 2008, 400 participants. Evaluation:

Initiation Date: Aug 2004 Type of programme: free programme including scheduled contact with counsellor Recommended/Scheduled duration of the intervention: 50 days

Programme elements:  initial chat session with a counsellor (50 mins)  diary  weekly feedback from the counsellor  final chat session Number of participants 2008: 524 Number of participants since Aug 2004: 2,145 Evaluation:

Structure of the survey Start-up- questionnaire Socio-demographics Cannabis consumption (quantity, freq.) Psychological well-being Motives for / against consumption Consumption-related self-efficacy Delay-condition Participation at the programme 3 Months Follow-up Cannabis consumption (quantity, freq.) Psychological well-being Consumption-related self-efficacy Receiving of other treatment Evaluation of the „quit the shit“ Programme

Study Population: N=206 participants Cannabis: Consumption & dependence On average on 27 days during the last 30 days On average 15 grams during the last 30 days (high variance) 95% are addicted to cannabis (DSM IV) Retention rate 44% of the participants completed the programme regularly Socio-demographic data Significantly more male participants (74%) Average age: 25 yrs. (MD) (youngest: 14 yrs.; oldest: 59 yrs.) Relatively high education: 49% attend Gymnasium (lycée) or have reached Abitur (bac) Evaluation of the „quit the shit“ Programme

T(187,02)=6,593; p<.001; d = 0,98 Results : Days of consumption within the past 30 days

T(166,969)=5,174; p<.001; d = 0,74 Consumed amount (grams) within the past 30 days Results :

Summary  The internet is a quite new area for preventing and treating drug use  Most of the EU member states provide informational websites.  All of the existing programmes target cannabis users who want to reduce or quit  There remains a lack of experience with these programmes  Some initial results seem to be promising  Further evaluation work needs to be done

Thank you! Dr. Peter Tossmann