Reducing alcohol and cannabis use risk in South American young adults: is behavioral economics an effective approach? Results from a randomized controlled pilot trial

The UN Saludable Trial was a randomized controlled pilot trial of a behavioral economics (BE) intervention designed to reduce the risk of hazardous alcohol and cannabis use among young university students from a large public Colombian university. The trial aimed to determine the feasibility of delivering a BE intervention and to explore its preliminary efficacy compared with a personalized normative feedback (PNF) intervention. A total of 709 young Colombian adults were recruited, and 470 were randomly assigned to receive either the BE intervention or the PNF comparison intervention. Changes in outcomes were assessed at 1-month and 6-month follow-up. The BE intervention resulted in a statistically significant decrease in the amount of alcohol and cannabis consumed per week, as well as a significant reduction in the time spent using these substances compared to the PNF intervention. However, we observed a significant dropout rate, with approximately 10% of the participants who were initially randomized completing the entire follow-up period. To our knowledge, BE approach has never been applied before in South American countries to address and prevent hazardous alcohol and cannabis use in young adults. Overall, the current findings suggest that an intervention combining monetary incentives with decision-making tools may be a promising approach to prevent the progression towards high-risk use in young South American adults. Schools and universities should promote a safe and healthy learning environment for all students by implementing effective drug prevention programs. Further research is needed to replicate these results and explore suitable ways to reduce the dropout rates.