Alcohol, Smoking, Drugs: Can Digital Solutions Give A Helping Hand To The Addicted?
Alcohol content measuring wristbands, smart lighters, nicotine tracking wearables, stop smoking apps, virtual reality therapies, automated messaging platforms are the newest elements in the arsenal of digital health technologies supporting everyone in the fight against addiction to cigarettes, alcohol or drugs.
Addiction and dependency ruins lives
Once you become addicted, it sticks with you for a long time, if not for life. It doesn’t matter whether it’s about cigarettes, alcohol, medication, drugs, gambling, sex, etc., any of these substances or phenomena could cause you strong dependency and might impact your everyday life negatively.
Just as in the case of chronic diseases, you will wake up and go to bed with it every single day. You may overcome the lowest points, but even if you manage to battle the substance – and yourself, for that matter –, the skeletal ruins of addiction will wait in a shadowy corner to retake shape due to a breakdown induced by psychological or environmental factors. As a worst case scenario, addiction eats up your life, your family’s lives – and in huge numbers even entire communities.
The global statistics are disquieting. A study found that in 2015, the estimated prevalence of heavy episodic alcohol use was 18.4 percent in the adult population; 15.2 percent in the case of daily tobacco smoking; and 3.8, 0.77, 0.37 and 0.35 percent for past-year cannabis, amphetamine, opioid, and cocaine use, respectively. European regions had the highest levels of liquor and cigarette consumption. Relapse rates are even more worrisome. The U.S. National Institute on Alcoholism and Alcohol Abuse has cited evidence that 90 percent of alcoholics will experience at least one relapse following treatment, and that’s around the same rate in the case of nicotine and heroin as well. The average relapse rate for drugs is between 40-60 percent, meaning that treatment and rehabilitation need to be persistent and planned for long-term.
How could digital solutions come into the picture?
Thus, it takes enormous willpower coupled with professional help, a supportive social environment, appropriate medical infrastructure, and consistent follow-up procedures to get out of the unbearably deep hole of addiction.
In this context, disruptive technologies could act as additional tools for the management of preventive or reactive treatment for both victims and physicians. Medical treatment, psychological or psychiatric therapy (as addiction goes hand in hand with mental health disorders) cannot be replaced by any digital solutions. However, these can act as indicators for substance use and thus help realize the problems, or aid prevention programs and support the recovery process.
Here, we collected the most useful digital means in the fight against alcohol, tobacco and gambling problems. We will briefly touch upon the issue of drug abuse and the potential role of digital health in the opioid crisis, too, however, we recommend an earlier and more comprehensive article about the topic here.
Alcohol is responsible for 1 in 20 deaths globally
The war on alcohol is the trickiest when looking at the fight against substances. Contrary to every other case – no matter whether it’s smoking, drugs or gambling -, there is a prevalence of high social pressure to drink. The ritual of consuming wine, beer, gin, whiskey, vodka, cocktails, rum, absinthe, cognac, tequila – the list could go on and on – is so deeply rooted that not even the “sobering” death and addiction rates or alcohol-related diseases discourage people from booze. Although the American prohibition on alcohol in the 1920s brought down consumption levels for a while and many regions such as Norway, Finland, Iceland or Russia experimented with bans on liquor, in the end, it turned out that population-wide constraints only work in countries with embedded social beliefs against alcohol. Just think about the Muslim countries, such as Saudi Arabia.
Nevertheless, alcohol is a powerful drug and takes too many lives. In the latest WHO report released in September, the organization says that more than 3 million people died as a result of harmful use of alcohol in 2016. This represents 1 in 20 deaths. More than three-quarters of these deaths were among men, although the most striking piece of data is that harmful use of alcohol causes more than 5 percent of the global disease burden. Globally, an estimated 237 million men and 46 million women suffer from alcohol-use disorders, and high-income countries in Europe and on the American continent lead the way.
With wristbands and apps against liquor
Various technologies, such as apps, trackers or online programs aim at the prevention of excessive alcohol use or at the treatment of existing alcohol problems.
As in the majority of substance abuse cases, prevention is of utmost importance. While comprehensive research found that the best for our health would be not to consume alcohol at all, methods for moderation in consumption can already help avoid more severe health-related problems, issues around binge drinking or addiction.
Many apps such as AlcoDoid or Daybreak could help the users track how much alcohol they consume and get a clearer picture about their stance towards liquor. A wearable called Skyn, which looks like the sort of wristband runners wear to measure their speed and heartbeat, calculates the body’s alcohol content. Three-quarters of an hour after drinking, the Skyn’s wearer can see their blood alcohol content (BAC) on the wristband. The Proof smart bracelet, unveiled at CES 2017, offers something similar. The wristband is connected to an app, which can tell you the BAC and how long until you’re likely to be sober again. These could be useful for people aiming to cut back on liquor, but also for those who want to stay below the maximum BAC level for driving.
On the other hand, many programs have the intent to support alcoholics in their journey towards absolute sobriety, too. For example, the app called Twenty-Four Hours a Day offers daily meditations including prayers or religious texts as crutches in the fight against booze, while the 12 Step Guide – AA is based on the program of Alcoholics Anonymous (AA) and includes a sobriety calculator. Beyond smartphone applications and wearables, within the framework of a pilot program in Belarus, Brazil, India and Mexico, the UN launched innovative e-portals with self-help intervention tools, among others providing a self-screening tool for hazardous and harmful use of alcohol and a fully computerized self-help programme for people who wish to reduce or stop drinking alcohol.
Lives going up in smoke
In spite of the overarching campaigns against smoking in numerous (highly developed) countries – bans on smoking in public spaces, restrictions on tobacco advertisements and marketing channels -, the statistics around tobacco-related issues are no less disappointing than in the case of alcohol. One reason is that while the attitude in European countries and the US strongly goes against smoking, tobacco companies are massively advertising in the developing world, especially Africa and Asia – where the numbers of smokers soar.
That’s frustrating on many levels, but primarily because it’s almost common knowledge that smoking increases the risk of death from ischemic heart disease, cancer, stroke, and respiratory diseases. In 2016 alone, tobacco use caused over 7.1 million deaths worldwide (5.1 million in men, 2.0 million in women). Most of these deaths (6.3 million) were attributable to cigarette smoking, followed by secondhand smoke (884,000 deaths).
Stop smoking apps, smart lighters and co.
Luckily, health tech developers are creative when it comes to aiding individuals desperately searching ways how to stop smoking. One of the most popular ways is to download an app coaching you to develop a personalized plan for quitting. Quit Smoking: Cessation Nation, Craving to Quit or QuitNow! all offer virtual aids in case you want to stop with the fumes.
Going beyond apps, a US-based company, Chrono Therapeutics, developed a digital transdermal patch that releases nicotine at timed intervals when cravings are strongest. Seventy-five percent of smokers have their first cigarette within 30 minutes of waking up, and this digital nicotine patch solves the morning craving by providing support even before the craving strikes. Other tools include smart lighters, such as the Quitbitlighter and cigarette cases or nicotine tracking wearables that track smoking and support the consumer by providing insightful feedback on making healthier decisions.
Also, researchers at Case Western Reserve University are using wearable sensor technology to develop an automatic alert system to help people quit smoking. The smartphone app, initially limited to Android-based operating systems, automatically texts 20- to 120-second video messages to smokers when sensors detect specific arm and body motions associated with smoking.
Digital technology will not leave drug addicts behind
The most painful and destructive substances with the lowest rates of rehabilitation success are ‘hard’ drugs. Opioids, heroin, cocaine, methamphetamine and the like are incredibly tough to fight. Today, more Americans die from drug overdoses than car crashes or gun fatalities. In all, drug overdoses killed 47,000 people in the U.S. in 2014. That’s 130 deaths per day, on average. The majority of those deaths – 29,000, or 80 per day – involved an opioid. Currently, the American Society of Addiction Medicine says that more than two and a half million Americans have an opioid-use disorder. Looking around in the world, the statistics get not an inch more reassuring. The number of people using drugs has been steadily increasing in the last years. According to the UN Office on Drugs and Crime, 255 million individuals were frequent consumers in 2015.
Although disruptive technologies cannot replace medical treatment or psychological guidance here either, artificial intelligence, digital maps, various smartphone apps or electronic prescriptions might aid the process. An exciting alternative presents itself with the appearance of virtual reality as a way to avoid the use of prescription painkillers or as a strategy of distraction at the time of craving during the rehabilitation process. Yet another effort came from the FDA in May 2018: the agency launched an innovation challenge to ramp up efforts to use mHealth and telehealth to combat the nation’s opioid abuse epidemic. The initiative shows the belief of the FDA to be able to mitigate the destruction of the crisis with the development of new digital tools.
It’s not a surprise that experts think that way. A couple of days before the campaign start, researchers from the Washington University School of Medicine in St. Louis announced in a study that an automated mHealth messaging platform was able to help people deal with opioid abuse to curb their cravings. The platform pushed out automated phone calls or SMS messages as frequently as daily, having asked patients whether they had used opioids in the last day or if they had an urge to use. An affirmative answer triggered follow-up questions and a three-leveled triage system, allowing the care team to ask more questions, send an alert to a care manager to contact the patient or schedule an emergency visit. After three months, the use of opioids significantly dropped. Although more research is needed regarding the topic, the preliminary results are encouraging.
As cigarettes, booze or drugs promise an easy way out of troubles or just a solution to have a great time – or at least a better one than experienced everyday-life situations, the war on addiction gets tough beyond belief. Coupled with mental health problems, financial troubles or issues in an individual’s environment: it seems to be almost impossible to do anything. We are not saying that digital health technologies work wonders here, as they might represent just one tool in an arsenal, but they could prove to be a useful tool in the hands of the ones who have the willpower, professional help, and a supportive environment to get out of the dark valley of addiction.
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