Introduction: Inpatient detoxification provides a safe environment for withdrawal from alcohol and/or other drugs, as a possibly vital step towards behavior change. However, many patients relapse soon after discharge from detoxification treatment and readmission is common. Estimates from the US indicate that only every sixth patient seeks and accesses post-detoxification treatment of substance use disorders (SUD). In this two-phase project, we aim to (1) investigate the post-detoxification treatment gap and related patient-reported factors, and (2) develop and evaluate a self-guided digital intervention delivered after discharge, with the aim of increasing post-detoxification treatment.

Methods: We have collected data for a registry-based mapping of patient flow from inpatient detoxification to outpatient treatment (N = 9,771) and conducted qualitative interviews (n = 23) on patients’ perceptions of barriers to treatment. These preparatory studies inform the ongoing development of a digital intervention, to be evaluated using a quasi-experimental interrupted time series design. We have conducted a simulation-based power analysis to estimate the minimum detectable effect size.

Preliminary results: In addition to general person-related (e.g. stigma) and treatment-related (e.g. low accessibility) barriers to SUD treatment, interviewees reported context-specific barriers, most notably psychological vulnerability following discharge, which for some triggered a reluctance to experience in-person contact. Digital support may thus respond to their needs. In the simulation-based power analysis, we ran 10,000 simulations for each of a total of 128 scenarios, varying intervention length, effect size and change curve. Results suggested that the study, given a 1-year intervention period, an alpha level of .05 and power level of .8, will be powered to detect an absolute increase of at least 2% or 3%.

Discussion: To our knowledge, this is the first project to evaluate a digital intervention for promoting post-detoxification treatment seeking. By offering a cost-effective, scalable intervention with minimal exclusion criteria, the study will, in case of successful outcomes, provide a novel and sustainable approach to increase post-detoxification treatment- seeking in real-world settings.