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July 01, 2011

NIDA-funded researchers have for the first time demonstrated the economic value of a computer-based treatment as an adjunct to standard addiction therapy. Dr. Todd Olmstead of George Mason University and colleagues determined that adding Computer-Based Training for Cognitive-Behavioral Therapy (CBT4CBT) to standard care resulted in an expense of $21 for each additional drug-free urine. This compares favorably with the cost-effectiveness of other evidence-based addiction therapies. For example, prior research found that the clinic cost per additional drug-free urine obtained by adding prize-based contingency management to methadone maintenance was $70.

Dr. Olmstead analyzed data from a randomized trial led by Dr. Kathleen Carroll of Yale University. That trial demonstrated that adding twice-weekly access to CBT4CBT to the usual treatment helped patients at community clinics stay abstinent longer than the usual treatment alone (see "Computer-Based Interventions Promote Drug Abstinence"). The program closely follows the content and session structure of cognitive-behavioral therapy (CBT), an evidence-based treatment for addiction. The manual for CBT is available at A Cognitive-Behavioral Approach: Treating Cocaine Addiction (Archives).

Although other researchers have demonstrated that computer-assisted delivery of cognitive-behavioral therapy offers good value in treatment of anxiety and depression, experts had not conducted cost-effectiveness analyses for computer-assisted addiction therapies. The new findings of Dr. Olmstead and colleagues suggest that CBT4CBT may be a cost-effective way to expand access to CBT for addiction. Moreover, if the CBT4CBT program remains effective when patients use it from a home computer or over the Internet, the value and reach of this e-therapy may expand dramatically.

Drug and Alcohol Dependence 110(3):200–207, 2010. [Full Text]