This is an interesting concept and it sounds promising, but doesn't it presume a willingness to participate (and admit you have an issue with drinking)? These days, we are all bombarded with so much spam email and unsolicited online info - it is all to easy to hit the delete key. I would think this is especially true when someone is in denial about needing any help.

Sounds like a study that received the results it was looking for, does not state level of motivation or seriousness of substance involvement if a person goes on line to find a solution to a problem I would imagine a positive outcome should result. Unfortunately this is the disease of denial.

Two things caught my attention: 1.Lack of human interaction or communication. Is that really in the best interest of humanity or the overall improvement in quality of life for those suffering from some level of substance abuse? Or anybody else for that matter. 2. How easy is it to manipulate the results. Can a person enter whatever they want regarding amount and frequency of use. If so, sometimes that self disclosure is somewhat less than reliable. Especially when attempting to present thyself as a "normal drinker". What I would view as fairly reliable is observed or documented changes in behaviors. The study stated that there was no significant differences in harms associated with alcohol between the two groups. It may be a nonscientific assertion however, if a large group of people (and a particular program design) are being credited with a significant reduction in amount and frquency of use yet the individuals are still suffering (as would be all of society)the same alcohol related harms as the control group; what's to be gained? Is there any chance the alcohol industry (I believe that industry is well versed in the association of alcohol use and disclosure of use amount and frequency that are less than forthright, honest and open)helping to fund or in some way influence outcomes any of the so called evidence based online interventions?

I also noted that there was no difference in harm, despite presumably significant differences in frequency and amount. Perhaps the measurement of harm needs to be clarified. I also remember seeing other computer generated interventions as ultimately unsuccessful despite initial glowing reports of success. Call me skeptical.

The article specified that the survey was sent to 13000 undergraduates, 7237 responded, 2435 scored in the hazardous/harmful range (≥8) and were randomized, and 2050 (84%) completed at least 1 follow-up assessment. All students in the harmful range were randomized, regardless of personal motivation and the goal of treatment was specifically to motivate and dispel misinformation. Given this context, these results are quite promising. Any effort that is that broad and diffuse, low cost and noninvasive and still has results is useful for exactly those people who are NOT yet motivated. If they were motivated, than other in-person treatment efforts would likely be more appropriate for them and maybe following this, increased motivation would bring them to these treatments.

Majority of youth spend their free time on the web. If we're not reaching them where they are, every other intervention/prevention/therapeutic effort is in vain! According to the National Comorbidity Replication Survey (2005), 50% of all lifelong mental illness occurs before 14 yrs of age and 75% occurs by 24 years. Youth are most in need of mental health services yet least likely to seek help http://tinyurl.com/nujkzh Having online options is perhaps the best way to reach this target audience. Paul Radkowski