Episodic Future Thinking as an Intervention for Alcohol Use Disorder: Effects on Delay Discounting and Real-World Alcohol Consumption

Episodic future thinking (EFT) is a promising intervention for alcohol use disorder (AUD) as it has been shown to decrease delay discounting (DD) and alcohol valuation. In the current randomized controlled trial, we evaluated the effects of EFT on DD, behavioral economic demand, and daily measures of real-world alcohol consumption among individuals with AUD. Sixty-four non-treatment-seeking adults with AUD who wished to reduce or quit drinking but had no immediate treatment plans were randomized to EFT (n = 34) or control episodic thinking (CET; n = 30). Participants completed four in-laboratory sessions over the course of five weeks, and a follow-up in-laboratory session one month after the completion of the intervention. Additionally, alcohol consumption was monitored remotely for five weeks via a digital app. EFT exposure acutely decreased DD relative to baseline and CET. Additionally, daily exposure to the EFT, but not to CET, decreased the number of drinks/day and the number of drinks/drinking day. Significant changes in behavioral economic demand were not observed. Overall, the present findings suggest that EFT is a promising intervention to decrease alcohol use with effects on real-world alcohol consumption among individuals with alcohol use disorder, but alcohol demand is not a mechanism of this effect.