Got Technology?

Back in 2004, NIATx Director Dave Gustafson got together with a group of creative thinkers from around the world. Their goal was to create a vision for the addiction treatment system of the future.  The result, after a couple of days of intense brainstorming, was a vision for addiction treatment that included virtual counselors and technology tools to track moods, manage cravings, and prevent relapse.

Dave wrote about that vision in Automating Addiction Treatment, an article published in Behavioral Healthcare in 2009. At the time, he and his team were just starting to develop A-CHESS, a mobile app to help people with alcohol dependence maintain their recovery after leaving residential treatment.

Today, the features dreamed about in that meeting in 2004 are part of A-CHESS and other mobile apps developed for addiction treatment and recovery. As Dave comments recently in the New York Times piece, Staying Sober After Treatment Ends:

"...evidence is that people in recovery need three things: social connection, motivation ("the desire to keep on keeping on") and confidence that they know how to cope with their struggles. Apps can help with all three."

Developing health information and communication technologies has become a major focus of research and development for the Center for Health Enhancement Systems Studies, which houses NIATx. For example:
  • A-CHESS is being adapted as a tool for integrating substance use disorder treatment with primary care. (See related post by Andrew Quanbeck.) 
  • A study team in Boston is testing a Spanish-language version of A-CHESS, called CASA CHESS, to reduce relapse and increase medication adherence among Latinos with co-ocurring disorders.
  • The A-CHESS "Bundling" project combines mobile health with medication-assisted treatment.
  • NIATx Deputy Director Todd Molfenter conducted a pilot study to test states' readiness to implement technology. A new study will expand on that work to provide more information on barriers to technology use in addiction treatment--and how to address them. 
  • The NIATx process improvement model is being used to guide development of other mobile health applications. 
  • Center scientist Dr. Esra Alagoz and a NIDA Clinical Trials Network team are developing a mobile app to help extend Motivational Interviewing training beyond initial face-to-face workshops. 
Are we there yet? 

A-CHESS and other mobile apps today include features that were hard to even dream of in 2004. For example: sensors, and their potential to give just-in-time information on health status.  

"I guess we never would have envisioned the number of sensors already built in to smartphones, like GPS, cameras, sound, and balance," says Dave. 

While technology is changing health care, Gustafson acknowledges that we're still a long way off from a transformed addiction treatment system. 

"In some senses, the Affordable Care Act and Wellstone legislation are creating an environment where health care providers must respond to the needs of people with substance use disorders, and payment for such services is much closer to becoming reality," comments Dave. "And with primary care being expected to take on behavioral health services and medication-assisted treatment, the world of addiction is looking more like the world of other chronic diseases." 

Keeping pace with technology

"One of the big challenges is designing systems that will be attractive and useful enough to be used for the long haul," says Dave. "We are getting better at that, but we're not there yet."

Another challenge for anyone interested in health care technology? Keeping up! Health care  technology is evolving so quickly that it's hard to keep up.

A few great ways for getting and staying informed about the latest technology innovations include:
  • Using Technology to Enhance Addiction Treatment, Thursday, February 25, 3:00 ET.  Free webinar hosted by thee SAMHSA-HRSA Center for Integrated Health Solutions and the American Telemedicine Association. Featured presenters include Nancy Roget, Director of the National Frontier and Rural ATTC. 
  • SAMHSA'S TIP 60: Using Technology-Based Therapeutic Tools in Behavioral Health Services.  Download the digital version for free from the SAMHSA website. Section 3 of this publication is a comprehensive literature review of the therapeutic use of communication technologies for behavioral health conditions. 
  • The National Frontier and Rural ATTC Telehealth Tuesdays. Tune in the second Tuesday of each month to find out more about the latest trends in telehealth for addiction treatment and recovery. 

Is your agency using technology to help patients achieve and maintain recovery? Share your story in the comments section below.

Addiction and the Bottom Line

Kevin Kirby, CEO and Founder

Financial sustainability is a hot topic in the recovery organization world. Most if not all recovery community organizations (RCOs) are highly dependent on public sector funding. This has left them vulnerable to budget cuts, shifting priorities, and broader economic downturns.

As a result of this unpredictability, RCOs are often forced to focus on the short term, with little opportunity to plan and execute long-term strategy or invest in innovations.

Our experience with Face It TOGETHER Sioux Falls has been driven by a business orientation and a belief that we could harness the forces of the market to transform how our community deals with drug and alcohol addiction.

Does smoking marijuana make you dumb?

January 25, 2016

Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx

That's just one of the 2,600  questions that teens asked researchers during NIDA's National Drug and Alcohol Chat Day, 2015.

And here's the answer, from Maureen Boyle, Chief of the Science Policy Branch in NIDA’s Office of Science Policy and Communications:
Regular use of marijuana--starting in the teen years--can impair brain development and lower IQ, meaning the brain may not reach its full potential. Here is an interesting infographic on marijuana use and your grades:

Addressing Leadership Needs for American Indian and Alaska Native Behavioral Health Workers

January 19, 2016

Lena Thompson, MPH
Research Support Coordinator
National American Indian & Alaska Native ATTC

Behavioral health disorders are highly prevalent in many American Indian and Alaska Native communities, both urban and tribal.

Combined 2003 to 2011 data indicate that American Indians or Alaska Natives are more likely than persons from other racial ethnic groups to have needed treatment for alcohol or illicit drugs in the past year (17.5 vs. 9.3 percent).  
     Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (November 2012). The NSDUH Report: Need for and Receipt of Substance Use Treatment among American Indians or Alaska Natives.  

Treatment approaches need to consider American Indian and Alaska Native cultures and healing practices, as well as the generational and historical trauma that affects native communities. In addition, the changing health care system in the US requires health care that health care leaders acquire additional knowledge and enhanced leadership skills to navigate both public and private funding opportunities, as well as administer a complex behavioral health agencies.

Want to learn more about Health Information Technology?

January 12, 2016

When Dr. Esra Alagoz was helping to develop SAMHSA's BHBusiness Plus course Planning for the Next Generation of HIT, she made sure that it included digital games and simulations.

“Our goal was to create an interactive course that keeps learners engaged and motivated,” she says.

Dr. Alagoz, Assistant Scientist at NIATx, specializes in educational technology. She teamed up with Amy McIlvaine, NIATx Educational Services Director, to create "Planning for the Next Generation of HIT."

Games and health information technology may seem like an unlikely combination--but games are already appearing in health information and will have an even bigger presence in the next "generation."

And there's a growing research base for games in health. The digital game SuperBetter, created by game developer Jane McGonigal, has proven effective at relieving depression in a randomized controlled trial.

Helping you help pregnant women and their families: The new ATTC CoE-PPW

January 5, 2016

ATTC Center of Excellence on Behavioral Health for Pregnant and Postpartum Women and Their Families: Working to Strengthen the Behavioral Healthcare Workforce's Ability to Serve Pregnant and Postpartum Women

Sarah Knopf-Amelung, MA-R
Research Associate, Special Projects
Mid-America ATTC

It’s hard to read the news without coming across an article relating to pregnant and postpartum women (PPW) and substance use. Whether it is states’ efforts to criminalize substance use during pregnancy or innovative treatment programs transforming the lives of pregnant women and their families, this topic is at the forefront of national media, as it should be. Perhaps one of the most discriminated groups of people who use substances, pregnant and postpartum women face extensive barriers to treatment and recovery. And yet, their success in accessing such services and achieving recovery has far-reaching implications for not only their personal well-being but that of their families and our communities as well.

Last-minute gift idea: Mindfulness

Maureen Fitzgerald
Communications Coordinator, ATTC Network
Editor, NIATx

Dec. 22, 2015

The holidays can be difficult for people in recovery and keeping the season stress-free for everyone can be tricky.  UW Health Psychologist Dr. Shilagh Mirgain  offers some great suggestions for reducing stress in this post from the UW Health E-Newsletter, Give the Gift of Mindfulness this Holiday.