Soberlink is a comprehensive alcohol monitoring system designed to remotely monitor a person’s blood alcohol concentration (BAC) and provide accountability for users to support recovery from Alcohol Use Disorder (AUD)1. Soberlink has been helping people in their recovery from addiction since 2011. In recent years, Soberlink has been working to advance its scientific evidence base by demonstrating the impact of using Soberlink on whole-health outcomes through rigorous outcomes data collection. Beginning in 2019, Soberlink partnered with OMNI Institute (OMNI) to study outcomes data from Soberlink clients. OMNI is an independent nonprofit, social science consultancy that provides integrated research and evaluation, capacity building, and data utilization services to accelerate positive social change.
OMNI worked with Soberlink to design a research study to understand the impact of using Soberlink on individuals’ recovery and health outcomes. Study participants were recruited from individuals enrolling in the Share Program, a program within Soberlink that allows participants to share Soberlink test results (reliable and accurate data on BAC) with a “recovery circle” of trusted individuals in their support network such as loved ones, sponsors, and/or therapists. This study was designed to gain deeper insights into participants’ experiences using the Soberlink technology; identify short- and long-term sobriety and other health outcomes for clients; and to better understand the impact of Soberlink, specifically for individuals who include a licensed therapist in their recovery circle.2
This report summarizes findings based on data shared by the current study’s 100 participants.3 Slightly more than half of participants identified as male and their ages ranged from 25 to 74. Generally, study participants had similar demographic characteristics and were white, not Hispanic or Latinx, highly educated, employed, and earning high salaries. A small percentage of participants reported previous criminal justice system involvement.4
The following sections highlight the study results most relevant to Soberlink Share Program experience and program outcomes. For a more complete summary of the study that includes findings related to program adherence, mental health outcomes and treatment engagement, and general helpful and challenging aspects of recovery, please visit omni.org/soberlink-research-study-full-report.
1 For additional information about the Soberlink System functionality and data security, see Appendix A.
2 For additional information about study objectives, design, and methods, see Appendix B.
3 Throughout this report, “participants” refers to Soberlink Share Study participants unless otherwise stated.
4 For additional information about study participant demographics, see Appendix C.
The following section outlines results associated with the study’s first research goal of gaining insight into participants' experiences and satisfaction with Soberlink though the Share Program. It is important to note in this section and throughout the report that participants were given the option to skip questions and display logic was used for some questions. As such, not all participants responded to all questions on the survey. Sample sizes are indicated (i.e., n=) for questions where at least one participant did not provide an answer.
Participants were asked about their experiences using the Soberlink technology for their recovery process at each follow-up (1-month, 3-month, 6-month). Participants were asked to rate a series of related statements using a scale from strongly disagree (1) to strongly agree (5).
5 There was not a significant change over time in Soberlink satisfaction (p = 0.86).
Participants described the most helpful parts of the Soberlink Share Program in open-ended responses. Responses largely fell into six main categories: accountability, family, routine and structure, relapse prevention, accomplishment, and freedom.
Individuals using a Soberlink device receive a positive test when a BAC above zero is detected. For participants in the Share Program, if a positive test is confirmed, a client’s recovery circle receives a notification or an automated report, depending on user settings. See Appendix A for more information about Soberlink protocol for positive tests.
Participants who indicated at least one positive test were asked about the impact of the positive test by rating statements on a scale from strongly disagree (1) to strongly agree (5).
6 There was not a significant change over time in positive test experience (p = 0.28).
The following section outlines results associated with the study’s second research goal of understanding short- and long-term outcomes for Soberlink clients. Questions about participants’ recovery-related outcomes, including substance use, treatment engagement, mental health, quality of life, and recovery capital were asked at one-month, three-month, and six-month follow-ups
Also included in this section of the report are results related to the third study goal of exploring possible differences in outcomes for Soberlink Share Program participants who have a licensed treatment professional in their recovery circle versus those who do not. 50 study participants had a treatment provider in their recovery circle and 50 participants did not have a treatment provider in their recovery circle. The two study groups were created by asking participants whether there was a treatment provider in their recovery circle at the time of enrollment and participants were enrolled until there were 50 individuals in each group (i.e., groups were not randomly assigned). Because the two groups were naturally occurring, we tested for demographic differences between the two groups to understand any key demographic characteristics that may have differentiated the groups. There were no significant differences in demographic characteristics between the groups.7 Areas where the groups differed in outcomes are highlighted throughout this section. Because the groups did not differ on key demographic characteristics at intake, it is more likely that differences in outcomes may be attributed to having or not having a treatment professional in participants’ recovery circles.
Participants were asked about substance use at intake, one-month, three-month, and six-month follow-up.
7 There were no significant differences between groups at intake in marital status (p = 0.47); education (p = 0.59); employment (p = 0.67); or income (p = 0.71).
8 There was not a significant difference between groups in alcohol use in the past week (p = 0.43) at intake.
9 There was not a significant difference between groups in alcohol use in the past month (p = 0.32) at intake.
10 Because so few participants reported abstinence in the past year, differences between groups were not examined.
At each follow-up, participants were also asked about their substance use since the last follow-up survey. Rates of abstaining from alcohol were high among participants, ranging from 73% to 77% across follow-ups. Rates of abstaining from other substances was slightly lower, ranging from 61% to 68%.
Overall, rates of sobriety from alcohol and substance use stayed high throughout the follow-up period for Share Program participants.11
Of those who reported using a substance in the past month, about half (51%) had used more than one substance in the past week at the six-month follow-up.
At follow-up, participants were asked to rate how troubled they felt by common issues of recovery. Participants could rate how troubled they were on a scale of not troubled at all (1) to very troubled (3).
11 There were no significant differences between groups in alcohol use at one- (p = 1.00), three- (p = 0.82), or six- (p= 1.00) months follow-up. There were also no significant differences between groups in substance use at one- (p = 0.31), three- (p = 0.48), or six- (p = 1.00) months follow-up.
12 There was not a significant change over time in how troubled participants felt by craving alcohol (p = 0.44). There was also not a significant change over time in how troubled participants felt by craving drugs (p = 0.95).
Participants were asked about substance use treatment at each follow-up. Understanding use of and re-engagement with treatment services helps demonstrate the level of care Soberlink clients need and if Soberlink contributes to individuals needing lower levels of care.
13 These changes are descriptive; inferential analyses were not conducted to assess whether the observed decrease over time was significant.
14 For all six levels of care there were no significant differences between groups in treatment participation at any of the follow-ups (p-values ranged from 0.09 to 1.00).
Participants primarily utilized lower levels of care, such as telehealth and outpatient services. Higher levels of care, such as detoxification and inpatient treatment were used less frequently. This suggests that Soberlink technology may be helpful in preventing more intensive and expensive treatment re-admissions. It may also demonstrate that clients receiving less intensive treatment, such as telehealth, are more likely to use the Soberlink device.
All participants had received treatment for AUD in the last six months at the time of enrollment into the study. At the one-month follow-up, participants with a treatment provider in their recovery circle reported higher rates of engagement with AUD treatment between intake and the one-month follow-up than participants without a treatment provider in their recovery circle.15
This result could indicate that Soberlink clients with a treatment provider in their recovery circle have closer relationships to providers and are in more frequent contact with these professionals. However, this difference was only marginally significant and was not seen in other indicators of AUD, such as alcohol use and AUD medication use. In short, despite differences in treatment engagement, the groups otherwise had equal levels of SUD severity at intake.
Participants who reported receiving treatment services between follow-ups were also asked about arrangement
As a whole, participants were very engaged in either formal aftercare or other support groups, such as Alcoholics Anonymous (AA). Participants could indicate engagement for more than one group so total percentages below add up to more than 100%.
15 The difference at one-month follow-up was marginally significant (p = 0.03). There were no significant differences between groups in AUD treatment at three (p = 0.22) or six (p = 0.45) months follow-up.
Participants’ quality of life was assessed using the EUROHIS-Quality of Life 8-item index. This is a shortened version of the World Health Organization Quality of Life Instrument-Abbreviated Version (WHOQOL-BREF) that has been validated and shown acceptable cross-cultural performance. Scores on this measure can range from 8 to 40, with a higher score indicating higher quality of life.
16 For all four aftercare options, there were no significant differences in attendance between groups at any of the follow-ups (p-values ranged from 0.36 to 1.00).
17 For participants with a treatment provider in their recovery circle, quality of life significantly increased over time (p < 0.001); for participants without a treatment provider, quality of life did not significantly change over time (p = 0.96)
Participants’ recovery capital was measured using the Brief Assessment of Recovery Capital (BARC-10) tool. Recovery capital is the characteristics and assets that a person develops in their recovery from a SUD. The BARC-10 is a validated questionnaire that assesses recovery capital using 10 questions corresponding to 10 domains that measure recovery capital. These domains include:
Scores on the BARC-10 can range from 10 to 60. Research has demonstrated that scores over 47 predict sustained remission for one year or more.18 The average recovery capital score for participants at intake was 48, indicating high recovery capital.19
18 Vilsaint, C. L., Kelly, J. F., Bergman, B. G., Groshkova, T., Best, D., & White, W. (2017). Development and validation of a Brief Assessment of Recovery Capital (BARC-10) for alcohol and drug use disorder. Drug and Alcohol Dependence, 177, 71-76.
19 There was not a significant difference between groups in BARC-10 scores at intake (p = 0.54).
20 There was a significant main effect of time on BARC-10 scores (p = 0.002).
All studies have limitations. In this section of the report, we note key limitations of the current study. First, findings may not be representative of all Soberlink clients. There were a number of eligibility requirements, including participation in the Share Program; engagement in AUD treatment in the previous six months; and that Soberlink results could not be used for child custody or legal circumstances, among others. Because the study took place during the COVID-19 pandemic, it is possible that a number of clients were excluded who had not received treatment due to the pandemic.
Next, findings may also not be representative of the impact that Soberlink use may have on the general population. The demographic characteristics of the participants enrolled in this study represent a group who is largely white, non-Hispanic/Latino, high earning, and employed. These demographic characteristics also tend to be related to quality of life and potentially recovery capital. Findings may vary in a similar study with a more diverse sample.
Finally, participants in the study group who had a treatment professional in their recovery circle and those who did not have a treatment professional in their recovery circle were not randomly assigned. While the groups did not differ on key demographic characteristics at intake to the study, it is still possible that differences in outcomes that did emerge between the two groups may be predicted by factors other than having a treatment professional in the recovery circle.
This study aimed to better understand Soberlink clients’ experiences using and short- and long-term outcomes of study participants. The study also looked at adherence to the Soberlink Share Program, including following the testing schedule and having the recovery circle receive all testing results. Eligible clients were asked to complete an intake survey and were contacted one-month, three-months, and six-months after to complete a follow-up survey.
Almost all study participants had an AUD. More than three-quarters of participants had abstained from alcohol at each follow-up time point. Engagement with AUD treatment services decreased over time; however, participation in AA and other support groups remained high across follow-up surveys.
Study participants had high recovery capital that significantly increased over the study period, as measured by the BARC-10. Participants also had high quality of life scores. Participants who had a treatment provider in their recovery circle showed significant increases in quality-of-life scores over the follow-up period, while the group without a treatment provider showed no significant change.
The majority of participants were highly satisfied with Soberlink and the Share Program and would recommend the device to other individuals struggling with AUD. Many indicated that Soberlink and the Share Program held them accountable, which helped their recovery journey.
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