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Stopping Substance Abuse? There’s an App for That

 5 min read / 

With the mobile tablet and smartphone applications market expected to grow to $80bn-$100bn by 2020, everybody wants a piece of the app pie. The Asia-Pacific market – particularly China and Southeast Asia – has overtaken the US market, and is expected to account for more than half of that total.

Gaming apps have dominated, but the market is expected to shrink, with music, video entertainment, finance and lifestyle growing in popularity. There’s even a smartphone app that will help you reduce your smartphone use, which seems counter-intuitive at best, oxymoronic at worst.

What is mHealth?

Other apps can be lifesavers, such as mHealth (mobile health apps), used in telehealth or telemedicine.

There isn’t an agreed-upon, precise definition of telehealth, but it includes the use of technology – a tablet, a smartphone – to gather and exchange health information between patients and physicians.

Telehealth or telemedicine services are now being covered by private health insurance providers in the United States as a means to reduce overall health costs and save lives. This includes enabling remote patient monitoring (RPM) with a doctor via smartphone when a trip to the emergency room is best kept as a last resort, such as during a natural disaster, such as a hurricane.

Reuters reported one such incident during Hurricane Irma’s onslaught on Florida. A woman whose daughter had a fever was able to contact a paediatrician using such an app. Through remote viewing via the smartphone, and performing a few tests under the physician’s direction, the woman was reassured that her daughter’s condition wasn’t serious enough that a dangerous dash to an emergency room – which might not even have power or be open – was necessary.

Mental Health and Substance Abuse Applications

Physical health isn’t the only area where such apps can be of help. So can mental health and addiction or substance abuse treatment. CNBC reported that desktop or mobile app administration of cognitive behavioural therapy (CBT) – sometimes called talk therapy or standard psychotherapy – can be effective for both.

The first week of October was the National Alliance on Mental Illness’ Mental Illness Awareness Week in the US, the second part of a one-two punch, following upon National Recovery Month in September. Apps that tackle the joint scourges of addiction and mental illness make sense as the two go together – a co-occurring disorder or dual diagnosis – about half the time.

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), although acknowledging that there are few such European programmes at present, and fewer studies evaluating their effectiveness, the initial results look promising.

First App for Substance Abuse Treatment Approved

In September 2017 the US Food and Drug Administration (FDA) approved the first prescription app for treatment of substance use disorders (SUD): reSET. It’s not a magic bullet, but it may help.

Developed by Pear Therapeutics – a startup that has raised more than $20m in venture financing – reSET provides a digitised version of CBT, probably the most effective treatment for long-term substance abuse. It’s intended to supplement, not replace, an actual therapist or stay in a substance abuse recovery centre. Like any app or therapy – even weight, exercise and diet monitoring – reSET only helps if patients use it.

Following a 12-week clinical trial, the FDA concluded that use of the app resulted in a “statistically significant increase” in rates of abstinence from alcohol, marijuana, cocaine, and other stimulants.

While reSET was not approved for treatment of opioid dependence – oxycodone, hydrocodone, fentanyl and heroin, the misuse of which has become epidemic – Pear Therapeutics says it awaiting approval of a similar, opioid-specific app.

Other Apps

Although reSET is the first app approved by the FDA, other software developers have jumped on the mHealth bandwagon, too. There are more than a dozen apps promising help with substance abuse that don’t require a prescription that are currently available – maybe two dozen if one includes diet, meditation, and exercise-related apps – including e-book versions of Alcoholics Anonymous’ Big Book for 12 step use, plus evidence-based apps suited for non-12 step rehab.

Local governments are getting involved, too. There is a smartphone app pilot programme underway in Ohio that uses GPS to detect when someone is approaching a “trigger area” and offers access to counsellors in off hours. It also is meant to be used in conjunction with other methods – counselling, medication-assisted treatment – not instead of them.

That app is only available to people in the pilot programme, but there are apps with similar features you can download for free.

Any help is welcome. The US National Institute on Drug Abuse (NIDA) says that substance abuse – including alcohol, tobacco, and illicit use of legal and illegal drugs – costs the US $740bn every year and drug-related deaths have tripled since 2000.

Continued Growth Expected in mHealth

As the app market grows, so too will mHealth. The global mHealth app market alone is expected to exceed $100bn by 2023.

In 2016 Europe had more than 31% of the mHealth market, followed by Asia and the US. That same year, the Progressive Policy Institute (PPI) reported that more than 321,000 jobs in the UK (1%) were related to app development – the largest number but not the largest percentage in the European Union.

It’s clear that smartphones will become ever more ubiquitous. Aging populations will tax medical services. Substance abuse rates will continue to rise. And governments will continue to look for cost-saving measures. The value and need for mHealth can only increase.

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