Anxiety and alcohol use disorder are among the most common mental health disorders. Anxiety is particularly common during emerging adulthood, when young people go through significant life changes. It is also common for young people to use alcohol as a way of reducing or coping with their anxiety, which can paradoxically make anxiety worse.
Often young people use alcohol to take the edge off their anxiety, for example having a few drinks at home before going out to a party. But over the longer term, using alcohol in this way can make anxiety symptoms worse. This vicious cycle between anxiety and alcohol use highlights the need for targeted support that address the interconnection between anxiety and alcohol use problems.
Inroads is an online, 5-module early intervention that addresses the link between anxiety and alcohol use in youth. The program helps participants to develop Cognitive Behaviour Therapy (CBT) coping strategies to manage their anxiety symptoms better and keep alcohol use under control. To optimise participant engagement, the program comprises interactive features and content developed specifically for young people, such as videos, real-life examples, and quizzes.
Researchers at the Matilda Centre conducted the first trial to assess the benefits of early intervention to concurrently address anxiety and hazardous alcohol use in youth. Results of this randomised controlled trial have recently been published in the Lancet’s’ EClinicalMedicine.
Between 2017 and 2018, 123 emerging adults (aged 17-24) with anxiety and hazardous alcohol use were recruited from across Australia. Participants were randomised to receive either the online Inroads anxiety and alcohol use program combined with low intensity psychologist support via email/phone, or an online alcohol information book (control group).
The Inroads program was found to have significant benefits compared to the control group. For up to 6 months after receiving the Inroads program, young people reported:
These results show the benefit of providing young people with CBT coping skills and addressing the inter-relationship between anxiety and alcohol use at this critical life stage.
"Although the control group reduced their drinking initially, their alcohol use had rebounded by 6-month follow up," explains Associate Professor Stapinski. "On the other hand, youth who received the Inroads program reported lower anxiety and made sustained reductions to their alcohol use."
So, what do the results mean? Associate Professor Stapinski says that "these results show the benefit of providing young people with CBT coping skills and addressing the inter-relationship between anxiety and alcohol use at this critical life stage."
The longer-term sustainability of these program benefits are currently being assessed in a 2.5 year follow-up study of participants.
Since the COVID-19 pandemic began, there have been reports of increased incidence and severity of anxiety and alcohol use problems in the Australian community. In 2020, the Australian Government Department of Health provided funding to support services and resources to reduce the impact of alcohol and other drugs during the COVID-19 pandemic. Part of this work involved enhancements of the Inroads program to include content to support management of anxiety and alcohol use in the context of COVID-19. Program adaption was conducted in consultation with the PREMISE (NHMRC Centre for Research Excellence in Prevention of Mental Illness and Substance Use) youth advisory board.
The program has also been updated for self-guided delivery, incorporating rule-based response algorithms to provide feedback, troubleshooting, accountability, and motivational support via customised auto-messaging in place of psychologist involvement.
The updated version of the Inroads program is freely available as part of an approved trial to determine the benefits associated with participation.
The trial is open to young people who:
If you or a young person you know might find the program beneficial please visit the Inroads website to find out more and register for program access.
The trial was funded by Australian Rotary Health and the National Health and Medical Research Council. The Inroads program is currently available through funding provided by the Australian Government Department of Health.