Digital therapies are emerging as a more accessible and efficient tool for seeking medical assistance, and have shown to be beneficial in helping people overcoming substance abuse issues. At a time when the UK continues to have the highest drug use rate in Europe, digital technologies could play an important part in tackling the problem of British substance misuse.
During the COVID-19 pandemic, countries around the world raced to set up digital platforms that could provide information, support, contact tracing and test results related to COVID-19. In Scotland and the rest of the UK, NHS apps were designed at an incredible speed to meet the demand and expectation of the public.
Now that contact tracing is no longer in operation and testing less widely available, the NHS aims to continue using these platforms to explore the benefit that digital technologies could have as we begin life after the pandemic.
As a significant cause of stress and anxiety for many, studies are already warning of the increase in mental health and substance abuse treatment needs as a result of the tight restrictions and lockdowns over the past two years, as well as the effects of pandemic drinking habits on society. Meanwhile, a great deal of work within the addiction field to battle the stigma of seeking treatment has coincided with waiting lists for substance abuse care rapidly filling up. Digital treatment and care aims to lessen the load on therapists, offering CBT and other behavioural interventions to those in recovery from addiction.
What Are Digital Technologies?
Digital technologies have already been around for a number of years and shown success in helping patients manage symptoms of chronic illnesses, substance use disorders, track and adjust medication, and engage with talking therapy.
Specifically, the software has been developed which runs the evidence-based therapeutic interventions of Digital Therapeutics. These interventions use a number of different technologies which can assist in treating, preventing, or managing a medical problem. The technologies include cell phones and other mobile devices, different types of sensors, a variety of apps – even virtual reality.
Digital Therapeutic products are held to the same standards of evidence and regulatory oversight as traditional medical treatments.
There are a wide range of digital technologies, with some available on the NHS and some requiring private payment. The UK government has released a plan for digital health and social care which has been described as a deeply ambitious and transformative programme.
The plan outlines initiatives including £2 billion of funding to support the implementation of electronic patient records (EPRs) in all NHS trusts as well as increase the availability of remote monitoring to help more than 500,000 people manage long-term health conditions at home.
Addiction Treatment and Digital Technology
The UK government statistics on drug and alcohol treatment paint a picture of increasing need and decreasing access to treatment. The most recent figures available on the number of adults with alcohol dependence are from 2018 to 2019. At this point an estimated 602,391 adults with alcohol dependency were in need of specialist treatment, a 2.6% rise from the previous year.
With 107,428 people in treatment for alcohol misuse in 2020 to 2021, based on the 2019 estimates, there were approximately 82% of adults in need of specialist treatment for alcohol who were not receiving it.
There are a range of different reasons why people don’t have access to specialist treatment for substance use including fear of stigma, financial reasons, and geography. Digital addiction treatment provides a flexible, private, and often more accessible option. Moreover, digital mental health support and talking therapy has shown to be successful as trialled by the NHS. With almost two-thirds of people starting addiction treatment saying they also had a mental health need, the accessibility of dual mental health and addiction support is important.
The UK government’s own statistics reveal that of the 110,095 people who exited the drug and alcohol treatment system in 2020 to 2021, half (50%) of individuals left having successfully completed their treatment, free from dependence. However this does not account for those who relapsed after their treatment finished. A lack of ongoing support after leaving rehab is a key driver of relapse. Digital therapies offer a flexible and low-cost option for continued addiction support and monitoring.
One example of a clinically tested digital therapeutic, and among the first approved therapies for substance use disorders, was reSET for the treatment of nonopioid use disorders and reSET-O for the treatment of opioid use disorders. These products are interactive-based therapies that provide cognitive behavioural therapy adjunct to a contingency management system for individuals over 18 who are participating in outpatient treatment under the supervision of a clinician. So far, studies have shown a reduced rate of dropout from treatment and increased abstinence when the digital therapeutic was used.
How are Digital Therapeutics Different from Wellness Apps
Digital therapeutics may appear to be a simple extension of the hundreds of thousands of wellness apps available. However, there are distinct differences namely, the specified form of clinical intervention or oversight that must be provided in order to be recognised as a digital therapeutic.
Digital wellness applications can provide useful, tailored support that ranges from sleep cycle tracking to managing screen time. While digital wellness apps do have positive contributions to health and can provide holistic care, they do not require the same inspection and monitoring as digital therapeutics. An application must be software-driven, evidence-based, and make a claim to prevent, manage, or treat a medical disease or disorder in order to be recognised as a digital therapeutic.
What are the Limitations of Digital Therapy?
Despite showing great promise in addressing growing rates of mental illness and substance abuse in the UK, there are limitations to digital therapy. Such programs may not be appropriate for those with severe or complex needs or those in crisis. Since online therapists are distant from the client, getting an urgent response can be difficult, although this could be said for any form of therapy.
Moreover, there may be some situations where digital solutions are simply not able to replace face-to-face therapy and inpatient care. This said, mental health and addiction experts who are in favour of digital treatments state that the goal is not for digital therapeutics to replace traditional face-to-face therapy but instead to allow therapists more time to see patients who most urgently require care.