Telehealth and Alcohol Use Disorder: Improving Engagement and Treatment Outcomes

Authors

DEBORAH A. Blackshire, University of LynchburgFollow

Specialty

Addiction Medicine

Advisor

Dr Debra Munsell

Abstract

Alcohol use disorder (AUD) contributes to more than 140,000 deaths annually in the United States, yet remains widely undertreated due to stigma, geographic isolation, and limited specialty access. The rapid expansion of telehealth during the COVID-19 pandemic offers new opportunities to address these gaps. This review examines evidence on the effectiveness of telehealth interventions in expanding access to care and enhancing engagement, retention, and relapse prevention among adults with AUD.

A literature search identified 12 peer-reviewed studies published between 2019 and 2025 examining video counseling, mobile applications, and telephone-based interventions for AUD. Included studies comprised randomized controlled trials (RCTs), systematic reviews, and implementation studies selected for relevance, quality, and clinical applicability.

Findings indicate video-based interventions improve engagement in rural populations, while app-based models yield lower retention among older adults. Relapse outcomes are mixed, influenced by study design and follow-up duration. One randomized trial (n = 581) reported a 30% increase in six-month treatment retention with video therapy compared with in-person care (65% vs 50%; p = 0.02). Another trial evaluating a smartphone application linked to a Bluetooth breathalyzer (n = 446) found a 38% reduction in heavy-drinking days over 12 weeks (mean 5.3 days vs 8.5 days; p < 0.001).

Effective telehealth integration requires attention to digital literacy, access, and policy frameworks. Physician assistants (PAs), given their training across medical and behavioral domains, are uniquely equipped to lead integrated telehealth care for individuals with AUD.

Recommended Citation

Blackshire DA. Telehealth and Alcohol Use Disorder: Improving Engagement and Treatment Outcomes. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).