It’s no secret that America is facing an addiction crisis. The Centers for Disease Control and Prevention released data showing that drug overdoses killed more than 72,000 Americans in 2017, a record high. This epidemic is so bad that it may have been responsible for the drop in overall U.S. life expectancy from 2015 to 2017 of 0.1%. This decline marks the first in more than two decades, the last time being at the height of the AIDS epidemic, and before that between 1962 to 1963 when influenza ravaged the country.
Lawmakers have rallied in response to these statistics by expanding access to treatment options and cracking down on pharmaceutical supply chains, yet there remains a barrier in the way of making significant progress. This problem is namely that treatment for drug and alcohol addiction needs a 21st century makeover. Modern treatment centers help thousands get sober every year, but there’s little concrete evidence to support the claim that one method of rehab works better than another, especially given that not all treatment centers use the same programs and individuals respond better according to different treatment models.
There’s also the fact that AA, one of the most popular treatment programs in the world, has remained largely unchanged since its birth from the Temperance Movement more than 75 years ago. There needs to be a more modern solution for people seeking recovery from drug and alcohol addiction. Modern medication is effective at getting people off harder substances, but it also carries the risk of patients getting hooked, such as with Methadone or Suboxone, only to have them grow tolerant and eventually relapse. One relatively untapped field in addiction treatment is advanced technology.
If we can use technology to increase our lifespan, make things more convenient, and myriad other miracles, then why can’t we use it to solve the age old dilemma of addiction? We may be approaching an answer. Here are several ways that tech companies are making strides in the field of recovery technology.
One possible answer to the dilemma of responsible pain management and withdrawal could be neuromodulation, also known neurostimulation. This type of technology works by sending electrical currents that interrupt pain signals in the brain, effectively relieving pain. Instances of this kind of technology have been around since the 1960’s, but it wasn’t until the advent of the first spinal cord stimulator approved by the FDA in 1989 that medical devices began making steps towards effective pain management. Since then, companies like Medtronic, Boston Scientific, and St. Jude Medical have produced neuromodulation devices intended for treatment following spinal cord injury or surgery.
Today, multiple newcomers to the marketplace are creating more powerful, compact neurostimulation devices for use in addiction recovery. Nevro, a California based company, received FDA approval in 2015 for a high-frequency modulator that could be subdermally implanted to treat pain. In a two-year study of nearly 200 patients, results showed that the Nevro device was better at relieving back and leg pain than all external spinal cord stimulation devices. Patients are able to try out the device in a non-intrusive format for one to two weeks before they decide to make the commitment.
Cleveland-based SPR Therapeutics also produces a less intrusive, matchbook sized stimulator that can be worn on the arm or elsewhere on the body. In one study by the National Institutes of Health, the device showed a 72% reduction in pain for users. Another external device called the Neuro-Stim Bridge was approved by the FDA in 2017 for treating opioid addiction.
The Neuro-Stim has been used by rehab clinics in 30 states to help people with withdrawal symptoms associated with opioids. The Neuro Stim Bridge is attached directly to the skin behind a person’s ear and sends electrical pulses that disrupt pain signals being sent through the brain. For recovering addicts, detox from substances like opioids, benzodiazepines, and alcohol can be a significant barrier to getting sober. In one clinical study on patients undergoing opioid withdrawal, subjects experienced a pain reduction of more than 30% within 30 minutes of using the device. After using the device for a period of five days, 88% of patients successfully transitioned to the next phase of their program.
With neuromodulation, patients can safely detox and enter into a rehab program where they can learn the tools for longer term recovery. Similarly, people who may be prescribed painkillers for an injury or following a surgery could use a neuromodulating device instead, eliminating the risk of developing an addiction.
One of the more difficult components of recovery is tracking patient success rates. It’s difficult to tell whether a graduate from a recovery program has remained sober unless they commit to repeated drug testing. Oftentimes graduates from recovery programs are simply called and asked whether they are using substances again. Several tech companies are developing more effective monitoring programs to help rehabs and clinicians better track their patient’s progress and prevent a relapse from becoming a full blown backslide into addiction.
One such innovation includes SoberLink, an FDA approved solution that uses facial recognition technology to confirm the identity of the user and an alcohol breathalyzer to measure blood alcohol content. The user simply confirms their identity through the device’s camera and simultaneously blows on a tube connected to the breathalyzer within. Results are seamlessly uploaded to the cloud and shared with relevant parties such as with personal physicians, probation officers, or rehab clinics.
Since its introduction, the technology has been utilized by leading treatment center names such as Hazelden Betty Ford, Edgewood Health, and The Lighthouse. Case studies from these and more treatment centers have demonstrated that the technology has shown success when integrated with a typical recovery program and has helped to de-escalate situations in which a patient suffers from a relapse.
Remote monitoring monitoring devices are also being used to ensure that patients do not misuse prescription medication such as opioids. Called “Abilify MyCite”, the first iteration of such devices received FDA approval in 2017 to help monitor ingestion of the antipsychotic medication Abilify, commonly used for treating schizophrenia and cases of bipolar disorder. The medication comes in the form of a small tablet containing a harmless microsensor. The user wears a small receptor patch that transmits the signal from the sensor to a cloud database.
This type of technology could be useful for elderly people with memory problems and those suffering from mental disorders that could hinder their likelihood to regularly take medication. However, it can also be used to help physicians track their patient’s opioid prescription adherence. Or at least that’s what one company, EtectRx, hopes to use these devices for following FDA approval in 2017. EtectRx’s product is a gel capsule that fits over the patient’s regular pills, and when swallowed, is dissolved and emits a radio signal that is picked up by a wearable device on the patient’s body. This device can transmit information to a physician and inform them of how many pills a patient has ingested.
Obviously, this type of technology has its limitations. For one, patients will have to consent to use the device, which may be more likely for those finishing rehab but might not be as readily accepted by the average patient looking to fill a prescription. There’s also the possibility that users find a way to open the capsule and extract the drug they wish to take. The results aren’t promising yet, as EtectRx cites a only small clinical study of 10 patients where 90% of respondents said they would be willing to continue using a digital pill monitoring program to adhere to their prescription.
Nowadays there’s a smartphone application for everything, so it should be no surprise that we’ve got apps to help people recover from drug and alcohol addiction. Smartphones offer the opportunity to be an effective treatment device because they go everywhere with us and keep our connection to the world intact at all times. A smartphone application can’t replace a sponsor, but it can help track where you are, give you daily motivation, connect you to resources, and help you track your sobriety.
A quick search into the app library of your smartphone will turn up hundreds of results for recovery apps. Most are some variant of daily motivation and progress tracking. For example, I Am Sober is a popular recovery application that includes a sobriety calculator along with daily motivational quotes and daily pledges for staying sober.
Another app, Reset-O, is the creation of Pear Therapeutics, which received FDA approval in 2017 to market their app for addiction recovery. The app is intended for people recovering from opioid addiction and includes clinically recommended cognitive behavioral therapy activities as well as financial incentives for reaching milestones. In a clinical trial with 400 patients, the app produced an abstinence rate of 40% compared to 17.6% for the control group.
Nomo is a popular recovery app built around a sobriety clock. You can track progress, share results among friends and social media, and connect with accountability partners that you can send notifications to when you’re feeling tempted to use again. The app also lets you earn chips by reaching specific milestones in your recovery and lets you see how much money you’re saving by not spending on your habit. A convenient “check-in” button allows you to keep in contact with sponsors and let them know you’re doing alright.
For those looking for extra failsafe features, WeConnect offers location tracking software that helps monitor whether you are near or inside liquor stores or bars and allows you to check in to make sure you are attending a particular meeting. It also includes an SOS button so that users can send an alert to emergency contacts to get in touch if they need immediate support. Like Nomo, the app includes a built-in rewards element that allows users to earn discounts and coupons as they complete milestones.
Technology is offering new methods of addiction treatment that have never been possible before. Given more time and investment, this field of research can hopefully offer more effective solutions to this epidemic that is gripping America.
Matthew Boyle is the Chief Operating Officer of Landmark Recovery, a growing chain of drug and alcohol rehab centers in Kentucky and Oklahoma. Matthew graduated from Duke University in 2011 Summa Cum Laude with a Bachelor of Arts degree and has worked in the healthcare industry ever since, creating a holistic treatment model that supports patients in the pursuit of achieving lifelong sobriety.