With millions of Americans grappling with substance abuse problems amid a worsening opioid epidemic, some addiction experts are reaching patients not in just their offices but also via phone.
A number of apps available via Apple and Android are targeting people with addictions, helping them to stay sober or quit smoking.
And some of these apps have been built by those specializing in addiction treatment.
The apps use proven therapeutic techniques like cognitive behavioral therapy (CBT), or acceptance and commitment therapy (ACT), which uses mindfulness techniques to help users via their pocket device.
The apps also allow people recovering from substance abuse to track the days they stay sober, or reach out to a support team if they are at risk of relapse.
How apps can help
Dr. Jaimee Heffner, PhD, and an assistant member of the Cancer Prevention Program at the Public Health Sciences Division at the Fred Hutchinson Cancer Center in Washington, helped develop a smartphone app called Smart Quit.
The app uses ACT to help people be more cognitive of their urges and their desire to smoke. The app also utilizes therapeutic techniques to help people overcome their desire to smoke.
Heffner said there are a number of ways that apps can help people with addiction issues, such as those addicted to nicotine.
“They’re low cost, and they’re available at any time and place,” she told Healthline. “That’s generally not true for any type of treatment that is delivered by a person.”
She pointed out that it can be difficult and time consuming to make appointments with a medical provider and get transportation or child care with traditional addiction treatment.
“There’s also a stigma around seeking help for substance use or any other type of mental health issue, which adds another layer of difficulty to getting assistance,” she said. “Apps can’t fully replace what a healthcare provider can offer, but they can be a great starting point or a tool to use alongside other types of assistance.”
Dealing with addictions
While smoking cessation apps are popular, some mental health experts have even tackled creating apps to treat serious illicit addiction like those to opioids.
In 2015, Brad Lander, PhD, a psychologist and clinical director of addiction medicine at The Ohio State University Wexner Medical Center, worked with computer science students, and doctoral student Brandi Spaulding, to create the Squirrel Smart Recovery app aimed at heroin users.
Lander told Healthline that he was interested in helping develop the app because it could help connect people more quickly.
“The idea is to sort of put a support network in your pocket,” he told Healthline. “When you have your trigger times it sends out an email or a text to your support network.”
He pointed out that many people are more comfortable with texting rather than calling. Streamlining that process could help people in crisis.
“People always have their smart phones with them, and a lot of people text instead of call,” he said. “If they are in trouble — calling — it’s too big of a step.”
The app helps users monitor their mood along with stress level and their desire for heroin, in addition to helping them track their days sober.
In addition to this tracking, the app helps people in recovery add in 10 names of family and friends so that if they feel tempted to use, they can quickly reach out to a network of support.
Bridging the gap
Experts say these apps can provide some help to users, who may not otherwise seek care.
Dr. Harshal Kirane, director of addiction services at the Staten Island University Hospital in New York, said this type of app has already developed into its own branch of medicine called “mobile health.”
“Over the last decade there’s been a steady and perhaps now exponential increase in the interest and subsequent development for mobile apps for a range of medical and mental health conditions,” he said.
He pointed out that these apps and other digital programs can bridge the gap, since access to recovery programs is still rare for many with substance abuse issues.
“There are profound treatment gaps in the U.S. and the world broadly for adults, only about 1 in 10 folks” who need treatment get it, he said.
He said for adolescents it’s even worse, with just 1 in 20 who need treatment are getting it.
“About 70 percent of people [have] smart phones,” he said. “You potentially have a way to connect with them.”
Kirane said there’s evidence that these apps can be effective in helping users stick with medication or other aspects of “treatment adherence.”
Don’t forget the personal touch
But it’s unclear if apps alone can lead to major behavioral change and sustaining that change.
“These apps do seem to reinforce folks staying in treatment or helping them connect,” to help or support, Kirane said.
Ramani Durvasula, PhD, a professor of psychology at California State University, Los Angeles, said there’s no reason that phone apps can’t be part of someone’s recovery from substance abuse.
“It has a behavioral aspect where you’re rewarding people,” Durvasula said of treatment programs like Alcoholics Anonymous. “It’s all carefully curated. [There’s] no reason that phones can’t get in the game.”
She said she’d expect these apps to be helpful for people in the initial stages of recovery.
“In the early part of maintaining and avoiding relapse, what you want to do is you want to maintain those healthy behaviors,” she said. “Something like the app can be helpful.”
However, the experts caution the apps should be used in conjunction with traditional therapeutic treatments and not as a replacement.
“Relationships are central to well-being and ability to recover from addictions,” Heffner
said. “Technology can assist with behavior change, but it cannot replace the value of human connection.”
Durvasula said she was intrigued by apps complementing therapy, but that she hopes no one thinks they can simply replace their mental health counselor with an app that costs $1.50.
“I think my biggest caution is that this is not a substitute for therapy,” she said. “I don’t know if there’s an app for someone who is trained for 20 years.”