Web-Based and Mobile Interventions for Substance Abuse Diagnosis and Treatment

Posted by Jenni Samuels.

Note – New technologies are frequently highlighted by members of the Health Technology Forum either as part of this blog, at regular meet-up sessions or at the Annual HTF Conference.  For more information about HTF and the upcoming June 2th Meet-up (Insights and Advances on Reimbursement for Telemedicine) please click here.

One of the biggest challenges in treating substance abuse and other forms of addiction is patient compliance. The very nature of addiction means that one of the hardest aspects of treatment is simply helping people get to the point where they’re willing and able to start. There are many challenges in creating health technology that people are willing to try—and to keep using—and this is certainly true of digital resources designed to help people overcome addiction. The ubiquity of smart phones and mobile devices provides a potentially significant way of delivering useful technology to recovering addicts.

The Immense Scope of the Problem

Of course, it’s not only illegal drugs that put people at risk; prescription drug abuse is still on the rise, with increasing numbers of people in multiple age groups becoming dependent on painkillers and other medications. In particular, young adults and people approaching or at retirement age are increasingly at risk. The incidence of prescription drug misuse in older adults may be as high as 26%. The risk level is high simply because older adults use more prescription and OTC medications than any other age group; meanwhile, the prevalence is increasing because of the sheer size of the baby boomer population, and the fact that this population as a whole is more willing to use both prescription and non-prescription drugs.

Data obtained from the 2010 National Survey on Drug Use and Health reveals that people aged 18-25 are more likely to be substance users, but are less likely to obtain treatment, in comparison to people aged 26-34. In the young adult age group, less than 10% of those with problems relating to substance use get appropriate treatment, meaning that young people are both more vulnerable, and less likely to get help. The same trends are occurring in mental health: young adults are more likely to be affected, but fewer than half of people aged 18-25 are getting the mental health treatment they need.

All of this puts tremendous stress on already strained budgets, in a wide range of healthcare settings. Public hospitals and health organizations, clinics, and detention facilities, all bear the high costs of treating substance abuse and related mental health problems. Untreated addiction and mental illness contributes to recidivism as well as to crime rates in general.

How Web-Based Technology can Help

In 2012, the World Health Organization launched a pilot program of online alcohol abuse information portals in Mexico, India, Brazil, and Belarus, for healthcare professionals as well as for the public. The websites include a screening tool that helps people determine if they have an alcohol problem, and an ongoing program—based on cognitive behavioral therapy—that people can use to help them reduce or stop their alcohol intake. Such tools have many important advantages: users can access them at any time, without having to book appointments or travel, they provide anonymity, and they cost nothing. They may be particularly useful in reaching young adults, who are more likely to be experienced internet users, and are less likely to seek other forms of treatment.

Apps for Recovering Addicts

A significant challenge that addicts face in recovery is that of replacing old drug-related habits with new ones that don’t revolve around the addiction; as well as this, the motivation to keep doing so is difficult to maintain in the face of psychological cravings and other pressures to return to the old lifestyle. Triggers that prompt cravings are unavoidable, and mobile devices are the ideal platform for delivering material that can help recovering addicts resist cravings, and maintain the momentum they need to form new, healthier, drug-free habits.

The AA Big Book is available in digital format, along with a new offering called the AA Companion, which provides readings and meditations on the original book, and a sobriety calculator tool. On the more sophisticated side, MIT and the University of Massachusetts created iHeal, an iOS app that uses a wrist sensor to track biological measurements such as heart rate and skin temperature. The user inputs additional data to enable the algorithm to detect high-risk situations, and the device offers advice and help when needed. Multiple mobile platforms offer tools with a wide range of functions, including sobriety counters that track sober days, inspirational quotes, images, and video clips, meditation, and relaxation.

Of course, by themselves, such applications are not substitutes for proven treatment and therapy regimes; however, they can be useful additions to a broader program of care, and may serve as lifelines for people who are unable or unwilling to seek other forms of treatment.

Sources

Alcohol Web India. Accessed May 20, 2014. Self-help tools for alcohol abuse.

Drug Abuse. “Meth Abuse.” Accessed May 20, 2014. Signs, symptoms and effects.

Kaiser Health. “Leaving Jail doesn’t have to Mean Losing Health Care.” Accessed May 20, 2014. Improving health outcomes for inmates.

National Adolescent and Young Adult Health Information Center. “Prevalence and treatment of mental illness and substance use problems in the early years in the United States. “Accessed May 20, 2014. Substance abuse in young people.

National Institute on Drug Abuse. “Strategic Plan.” Accessed May 20, 2014. Govt. strategies for reducing drug abuse.

Substance Abuse and Mental Health Services Administration. “Older Americans Behavioral Health.” Accessed May 20, 2014. Prescription medication use in older adults.

Technorati. “Addiction Recovery: Is there an app for that?” Accessed May 20, 2014. Mobile apps for recovering addicts.

Apple App Store. Accessed May 20th, 2014. Health and medical apps.

World Health Organization. “E-health technologies and substance abuse.” Accessed May 20, 2014. Web-based tools for recovering addicts.