Addiction Medicine: Closing the Gap between Science and Practice

reduction).* Similarly, patients who reported a
need for child care services and had their needs
addressed experienced a greater reduction in
their substance use severity score compared to
patients with child care needs who were not
matched to needed services (45 percent vs. 20
percent).† 416

The Use of Technology in Addiction Treatment and Disease Management ...................

An emerging approach to identifying, treating
and managing addiction--the utilization of online
computer tools and other technology-based
interventions to enhance access and delivery--is
showing some promising results.^417 These
include telephone contact with treatment
providers and e-mail, text messaging,
smartphone apps and online support groups.^418

Online approaches that employ evidence-based
practices via Web sites or tele- or video-
conferencing offer key advantages. They can
provide psychosocial therapies to patients at
lower cost than traditional face-to-face
approaches.^419 They allow patients who live far
from specialty treatment providers or who lack
resources to access psychosocial therapies or
supplemental services in a convenient manner.^420

Researchers are just beginning to investigate the
utility of technology-based services for patients
with addiction. While most existing studies are
methodologically weak or flawed,^421 a
randomized controlled trial of a digitally-
delivered smoking cessation intervention found
significantly higher long-term abstinence rates
compared to a control group receiving only a
self-help booklet (22.3 percent vs. 13.1
percent).^422 Another randomized control study
found that patients enrolled in a methadone
maintenance program who participated in
Internet-based group therapy sessions reported

• There was a 41 percent reduction among patients

who never reported needing the services. Patients
were not randomly assigned to receive services.
† There was a 31 percent reduction among those who

never reported needing the service.

greater satisfaction with the program than

patients who participated in traditional, face-to-

face group therapy sessions; reductions in

positive drug urine tests during the six-week

study were comparable between the two groups,

suggesting that Internet-based therapy may be an

effective treatment tool.^423 A recent study found

that a smartphone-based support system shows

potential for preventing relapse in addiction

involving alcohol;^424 however, further research

is needed on this particular program and, more

generally, on the outcomes of technology-based

services and how they compare to traditional

service delivery methods.^425

Concerns about technology-based services

include the risks to privacy and confidentiality

of information transmitted over the Internet,

safety and efficacy, and issues of licensing

posed by treatment delivered across state

lines.^426

Public Attitudes about Addictive Substances and the Need for Addiction Treatment ....

Although the American public appears to be

supportive of assuring that individuals with

addiction receive effective addiction treatment,

the view of most individuals about the relative

need for treatment for individuals who use

addictive substances and what constitutes

effective treatment does not match the science of

best practices.

Perceptions of the Relative Need for Treatment Based on Substance of Addiction.

CASA Columbia’s NABAS found significant

differences in respondents’ views of the type and

extent of substance use that indicates a substance

use problem and the need to seek treatment.

Public perceptions do not reflect the continuum

of substance use or distinguish between risky

use and the need for intervention versus

addiction and the need for treatment:

 The majority of respondents reported that

any use of the illegal drugs heroin (84.0