Digital health approaches for addiction

One of the most widely used texts in addiction treatment worldwide, the Oxford Handbook of Addiction Medicine, has recently been expanded and updated with Turning Point’s Head of Research and Workforce Development Professor Victoria Manning contributing to a new chapter on Digital Health Approaches for Addiction.

As a specialist in neurocognitive, psychological and other novel interventions to optimise treatment effectiveness – such as cognitive bias modification (CBM) – Professor Manning is well-placed to have written the overview of the latest advances in digital health approaches to addiction treatment.

“Over the past two decades, technological advances have revolutionised assessment and intervention approaches for people with substance use disorders and gambling,” she explains in the chapter.

Examples of the available technologies include online technologies, smartphone-based approaches and telemedicine techniques, as well as opportunities for digital technology to support continuing care.

“Importantly, digital health circumvents several barriers to face-to-face treatment, such as limited treatment availability and accessibility of services in some areas, work or childcare commitments, shame or fear of stigma, and cost,” Professor Manning says.

“It is not hard to imagine technologies detecting the availability of substances, or predicting use patterns or relapse risk …, creating opportunities to deliver tailored interventions that prevent or minimise harm from addictive behaviours when it matters most,” she adds.

Online or e-health interventions

As outlined in the handbook, e-health provides healthcare and support services through electronic communication, including videoconferencing, online resources and support forums.

Self-directed internet interventions, particularly those guided by therapists, have shown promise in reducing issues such as alcohol consumption, while also addressing barriers to traditional face-to-face treatment.

“Self-directed (or self-guided) internet interventions offering evidence-based psychological approaches such as cognitive behavioural therapy (CBT) have proliferated with promising research findings in terms of reduced alcohol consumption, or gambling problem symptom severity,” Professor Manning explains in the chapter.

“These tend to be most effective when they are therapist guided, in the form of emails or online messages from a therapist or coach, and less effective when targeting co-occurring disorders like anxiety and depression,” she says.

m-Health (mobile phone-delivered interventions

Mobile health (m-health) intervention apps provide various functions to support substance use reduction and recovery, including tracking consumption and encouraging goal-setting and mindfulness practices.

While many apps claim to be evidence-based, most lack rigorous evaluation, and only a few studies show significant reductions in substance use.

Despite these limitations, m-health apps extend access to evidence-based interventions and can serve as a valuable supplement to traditional treatment, especially when combined with support from healthcare professionals.

Wearables

Wearable devices can offer valuable insights into our physiological and psychological behaviours, such as sleep patterns and decision-making. These devices can monitor various health metrics, including heart rate and sleep quality, and provide real-time feedback to encourage behaviour change, such as reducing alcohol intake.

Despite the rapid growth of wearable biosensors for detecting substance use, further clinical evaluation is needed before they can be widely adopted in mainstream healthcare.

Artificial intelligence-based approaches

Artificial intelligence-based approaches are rapidly developing, utilising machine learning algorithms to identify individuals at risk for substance use disorders and facilitate early detection through tools like virtual assistants and chatbots.

These technologies can personalise interventions, provide ongoing support, and offer predictive analytics to enhance treatment decisions. However, as Professor Manning notes in the chapter, their effectiveness relies on the quality of the health information that has been provided to them.

Other computerised interventions

Computerised cognitive training has gained traction in addiction research, focusing on enhancing cognitive functions such as attention and memory to improve decision-making and reduce cravings.

The growing interest in virtual reality (VR) for assessing and treating substance use disorders also highlights the potential for personalised interventions.

Although further research is needed to ensure effectiveness and address concerns about data privacy and engagement, Professor Manning notes the value of these technologies in future treatment approaches.

Find out more and purchase the Oxford Handbook of Addiction Medicine (3rd edition).

Learn more about Professor Manning’s work developing neurocognitive, psychological and other novel interventions.

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