The application of digital health to the assessment and treatment of substance use disorders: The past, current, and future role of the National Drug Abuse Treatment Clinical Trials Network

• DOI: 10.1016/j.jsat.2020.02.005
• Publication Date: 2020-03-24T07:04:24Z
• Authors: Lisa A. Marsch; Aimee Campbell; Cynthia Campbell; Ching-Hua Chen; Emre Ertin; Udi Ghitza; Chantal Lambert-H...; Saeed Hassanpour; August F. Holtyn; Yih-Ing Hser; Petra Jacobs; Jeffrey D. Klausner; Shea Lemley; David Kotz; Andrea Meier; Bethany McLeman; Jennifer McNeely; Varun Mishra; Larissa Mooney; Edward Nunes; Chrysovalantis St...; Catherine Stanger; Elizabeth Saunders; Geetha Subramaniam; Sean Young
• Keywords: 360; Comparative Effectiveness Research; National Institute on Drug Abuse (U.S.); Substance-Related Disorders; Clinical Trials and Supportive Activities; Substance Abuse; United States; Brain Disorders; 3. Good health; Substance Misuse; 03 medical and health sciences; Good Health and Well Being; 0302 clinical medicine; Clinical Research; Behavioral and Social Science; Public Health and Health Services; Psychology; Humans; Mental health; Patient Safety; Generic health relevance; Health Services Research; Drug Abuse (NIDA only)

The application of digital technologies to better assess, understand, and treat substance use disorders (SUDs) is a particularly promising and vibrant area of scientific research. The National Drug Abuse Treatment Clinical Trials Network (CTN), launched in 1999 by the U.S. National Institute on Drug Abuse, has supported a growing line of research that leverages digital technologies to glean new insights into SUDs and provide science-based therapeutic tools to a diverse array of persons with SUDs. This manuscript provides an overview of the breadth and impact of research conducted in the realm of digital health within the CTN. This work has included the CTN's efforts to systematically embed digital screeners for SUDs into general medical settings to impact care models across the nation. This work has also included a pivotal multi-site clinical trial conducted on the CTN platform, whose data led to the very first "prescription digital therapeutic" authorized by the U.S. Food and Drug Administration (FDA) for the treatment of SUDs. Further CTN research includes the study of telehealth to increase capacity for science-based SUD treatment in rural and under-resourced communities. In addition, the CTN has supported an assessment of the feasibility of detecting cocaine-taking behavior via smartwatch sensing. And, the CTN has supported the conduct of clinical trials entirely online (including the recruitment of national and hard-to-reach/under-served participant samples online, with remote intervention delivery and data collection). Further, the CTN is supporting innovative work focused on the use of digital health technologies and data analytics to identify digital biomarkers and understand the clinical trajectories of individuals receiving medications for opioid use disorder (OUD). This manuscript concludes by outlining the many potential future opportunities to leverage the unique national CTN research network to scale-up the science on digital health to examine optimal strategies to increase the reach of science-based SUD service delivery models both within and outside of healthcare.