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Remote and digital tools added to in-person SUD care cut relapse odds by 39% (17 interventions; review of 34 RCTs)

A 2025 systematic review and meta-analysis of 34 RCTs (6,461 participants) found that remote or digital interventions supplementing in-person treatment reduced relapse odds by 39% (OR = 0.61, 95% CI 0.46–0.81, p = 0.001) and also reduced days of substance use (SMD = −0.18, 95% CI −0.28 to −0.08, 17 interventions, 2,566 participants). Where remote care fully or partly replaced in-person sessions, relapse odds fell 49% (OR = 0.51, 95% CI 0.34–0.76), though days-of-use reduction was non-significant in that condition (SMD = −0.08, p = 0.301).

Apps, text-based recovery support, telephone counselling and interactive platforms look like reasonable adjuncts to face-to-face SUD treatment, though over 70% of outcomes were at high risk of bias and the authors advise caution. Note the asymmetry: replacing in-person contact still cut relapse risk, but stopped moving days of use, so keep in-person contact where usage reduction is the goal. Attrition in digital addiction programmes is high; the authors link this to low adherence in online programmes with minimal human contact.

More than 70% of outcomes were rated high risk of bias, mostly from missing outcome data and retrospective self-report. Evidence is dominated by US-based, predominantly male samples (26 of 34 studies from the US), limiting generalisability to women, racialised minorities, and populations outside OECD countries.