How Can Substance Abuse Treatment Be Realistically Modernized?

Addiction is a slippery slope—one that's incredibly hard to get off of alone. Here's how therapy and technology are playing their part in making it easier.

By Mark Travers, Ph.D. | May 31, 2024

While each story of substance use disorder, or SUD, is unique—owing to personal history, substance used, genetic predispositions and environmental factors—there are often recognizable patterns in these stories. These patterns include the escalation of use, development of tolerance, experience of withdrawal symptoms and the psychological and behavioral changes that accompany the disorder.

Recognizing these patterns helps mental health professionals tailor personalized treatment plans that consider each person's specific needs. For decades, Cognitive Behavioral Therapy (CBT) has been one of the most widely used and effective treatment methods for substance use disorders around the world, and for good reason.

"Because CBT is structured, goal-oriented and focuses on immediate problems and practical solutions, it arms individuals with the skills needed to manage cravings, avoid relapse triggers and cope with stress and psychological symptoms that can lead to substance use," explains Dr. Suzette Glasner, Ph.D., a behavioral health expert and Chief Scientific Officer of substance use treatment platform Pelago.

How Effective Is CBT For Substance Use Disorders, Realistically Speaking?

As with many mental health interventions, the success rate of CBT for substance use disorder involves a complex interplay between the person's motivation to quit using, their genetic makeup, their relationship with their therapist and the level of support they receive from the people around them.

However, the most important factor in making CBT "work" is, perhaps, the availability of ongoing care and support from the therapist.

A 2019 meta-analysis published in the Journal of Consulting and Clinical Psychology found that while CBT shows significant effectiveness in the treatment of substance use disorders when compared to minimal or no treatment, especially in the short term, the positive effects of CBT can diminish over time without consistent follow-up and ongoing support.

While an ongoing support approach is promising in theory, it presents practical challenges. Therapists, who are key to delivering CBT effectively, are often spread too thin. The high demand for mental health services, a pervasive global issue, means that therapists may not always be able to provide the consistent, personalized follow-up care required for long-term success in treating substance use disorders.

How Is Technology Being Leveraged To Solve The Problem?

Those motivated to overcome their substance use problems often face the disheartening reality of relapses, which can occur swiftly and unexpectedly. Considering how traditional CBT delivery can be slow and methodical, it is not robust enough to combat these unexpected "failures."

Relapses tend to happen due to a few key factors:

1. Comorbidities. A significant proportion of people who struggle with substance use also struggle with other mental health issues, such as anxiety and depression. This may feel like an endless cycle of feeling low, using the substance to feel better and then falling below baseline once again.
2. Lack of social support. Those battling substance use disorder often find that their social circle is made up of other users, frustrated or disappointed family members or friends who have "written them off." Who do they turn to when they are going through a bout of intense craving? This is a precarious situation to be in, especially when one has access to a substance that promises to make everything "okay."
3. Stigma surrounding substance use. Although we are beginning to recognize substance use disorder as a serious mental health condition rather than a frivolous choice, many people still stigmatize substance use as an immoral action of a weak mind. This tends to deter people who are struggling with substance use from coming clean about the nature or extent of their usage, which can drastically affect treatment outcomes.

These factors paint a picture of how traditional methods of delivering CBT to those suffering can often be woefully ineffective in keeping them abstinent. However, we're finding out technology can be harnessed to fill the gaps left by a traditional therapeutic approach.

Today, almost everyone carries a smartphone—a device that potentially serves as a gateway to virtual treatment centers. It really is a question of whether in-person care trumps virtual care.

Drawing on her experience with such platforms, Dr. Glasner says, "The benefits of digital substance use programs are significant and have been demonstrated in multiple peer-reviewed clinical research, with outcomes meeting or exceeding those of traditional, in-person therapy. These benefits include increased access to care, convenience, flexible scheduling, a greater sense of privacy and reduced stigma."

Platforms like Pelago, which aim to empower the users to get clean on their own terms, show a lot of promise.

How Can You Help Modernize Treatment For Substance Use?

If you know someone struggling with substance use, empathize with them. Understand their hesitance to seek treatment or admit their issues. Treat them as active participants in their recovery—not as projects. They aren't addicts; they are people with a substance use disorder. They aren't victims of drug abuse; they are individuals who have developed an unhealthy dependence.

Pointing them to a virtual center for treatment can, in effect, put the ball back in their court. They can now leverage the ability to connect with a therapist on demand, use various virtual toolkits to fight off their cravings and have access to a wealth of knowledge on how to approach their mental health issues—substance use and the host of psychological turmoil that comes with it.

The U.S. is facing unprecedented levels of substance use. Each day we delay, more people fall through the cracks of outdated systems, succumbing to cycles of relapse and despair. Technology that is based on traditional care, as it turns out, is one of the most effective ways to assist those in need by bringing innovative solutions and successful treatment approaches directly to them.

A similar version of this article can also be found on Forbes.com, here.