After a hiatus I am returning to my beloved Digital Health Corner. I appreciate all my loyal followers and have attempted to bridge my absence with posts in other social media.
In a previous post I discussed important public health issues that digital technology can address. Among them is drug addiction. We are all aware of the opioid epidemic and the human destruction in its wake. However statistics have an impact that reaches beyond qualitative descriptions. According to the National Institute on Drug Abuse (NIDA) from 2001 to 2014, deaths due to overdoses in the USA were noted as:
- 8 fold increase due to prescription drugs
- 4 fold increase due to prescription opioids
- 6 fold increase due to heroin
- 5 fold increase due to benzodiazepines
- 42% increase due to cocaine
Tragic personal narratives provide a human fabric to the now commonplace trumpeting of generic news stories about the extent of the drug problem. An important keystone for any healthcare strategy for chronic disease is patient self-management. Giving patients tools to support them in their journey of recovery is imperative. Digital technology use in the addiction space is not a new concept. The use of computer-based programs for addiction prevention and treatment was described as far back as ten years ago. The creation of virtual resources for information, guidance and support is necessary to addicts who are, for the most part digitally connected. I will touch on some potential applications of digital technologies to all relevant stakeholders.
The NIDA of the NIH has a group of evidence-based screening tools for adolescents and adults to be used by health professionals. Notwithstanding this, many healthcare providers fail to utilize evidence-based treatments because they are not trained to do so. Technology can become a vehicle used to bridge this knowledge gap while also addressing logistical and economic challenges in drug treatment. Digital resources for families and caregivers are necessary as well.
There are various types of tech-assisted treatments. One is known as the Technology Educational System which is a multimedia approach focused on behavioral training. Another such program is the CBT4CBT (Computer-Based Training for Cognitive Behavioral Therapy). Studies of TES and CBT4CBT on outcomes and other endpoints are favorable. A nice summary of the studies by the NIDA discusses the impressive positive effects on abstinence.
The classification of substance abuse as a chronic condition by the ACA has implications with regards to digital health. It has spawned interest in telehealth as a treatment tool. There are medication assisted treatment (MATx) mobile apps to guide physicians in utilizing pharmaceutical drugs to treat addiction. It includes prescribing guides, clinical support information, and contact resources.
Drug addiction affects all age groups. Digital technology, especially mobile technology is not something to be used in a vacuum in this clinical setting. There are significant physical and mental health issues associated with opioid substance abuse which require human intervention, at times on a frequent outpatient or inpatient basis. However, as supportive mechanisms for providers, patients, and caregivers, it can facilitate better care, communication, and education. As in other areas of healthcare, the question as to which publicly available mobile apps are safe, useful, and supported by healthcare professionals is always present. This is, as readers of this blog know well, a topic for other discussions. The toll of opioid addiction on Society, the prohibitive cost of rehab, and shortage of mental health personnel and addiction specialists mandates a call to arms for quality accessible and effective mobile tools. I look forward to all the brilliant minds in digital health and those whose lives have been affected by addiction to step forward and not wait for a government ‘fix’ to this problem.