Illicit drug use in the United States is on the rise. Today, more than 25 million Americans aged 12 and above – 10 percent of the population – admitted to using an illegal drug in the past month. In 2002, the number was only 8.3 percent. The increase largely reflects a recent rise in cannabis use, the most commonly used recreational drug after alcohol.
Aftercare – The key to success
There is little disagreement that success in addiction treatment depends highly on aftercare. Without effective aftercare, treatments rarely last and relapse rates are high. Only one patient in four maintains abstinence over the first year following treatment.
Aftercare programs are expensive and labor intensive. It costs a lot of money to hire people to administer a consistent and effective program and money for mental health programs does not appear to be increasing in the near future.
In order to improve long-term results, a smartphone app has been developed to provide emotional and therapeutic support. Designated A-CHESS (Addiction Comprehensive Health Enhancement Support System), it has an audio-guided relaxation component and a global positioning system that can send an alert when the patient approaches a high-risk area, like a bar. The patient’s phone asks him whether he really wants to be there.
In a randomized study of A-CHESS against standard care therapies without it, the smartphone app improved several clinical parameters. But the thing that was most eye-catching was how it improved results as time went on. For example, at four months, A-CHESS demonstrated on 8 percent improvement in abstinence (which was not statistically significant over standard care), but at 12 months it showed a 12 percent advantage, which is significant both statistically and clinically.
How technology is changing the course of addiction treatment
Using technology to administer a therapy program normally administered by a human is already known to work. People today are very comfortable with technology, so introducing such programs is not frightening. The technology-based therapies are particularly effective when using equipment the patient already possesses. A limit in the past has been the need to invest in hardware and expensive software programs along with training personnel to administer them. That is less an issue today when so many potential patients practically live in their smartphones.
Technology makes it possible to consistently deliver therapy at times and places convenient to the patient. Some programs have already demonstrated their effectiveness.
There are still limitations, nonetheless. Distribution and education are still required. There is still much disagreement on how to optimize delivery and how to best integrate technology into existing systems. Smartphones are still no substitute for emergencies and unforeseen situations. The warmth of human contact cannot be replicated by a phone.
There are also privacy issues and, of course, just because the younger generation is comfortable with technology, it is often not the case for the older folks. Addiction, especially to pain medication, is not just a problem of youth.
Technology is not a complete substitute for treatment, but it can certainly help.