Sobriety gets the social treatment

More than one in seven people in the US struggle with substance abuse and addiction. That's 40 million Americans, aged 12 and older, with a substance problem.

For decades, a key part of nearly every accepted treatment for addictive behaviors involved face-to-face meetings. And no wonder: Research has shown that people who regularly attend in-person meetings at Alcoholics Anonymous and similar programs are more likely to stay sober longer. Another found that personal support was a key element of participants' recovery, helping them stay motivated while reducing symptoms of depression.

"The key to sobriety is relationships," said Peter Ruderman, a psychoanalyst at the St. Louis Psychoanalytic Institute. "People go to 12-step programs seeking relationships, and they get tremendous support from the group."

That's great for people who can actually get to a meeting, but not so helpful for those who live too far away. That's where social media and mobile apps could help. The National Institutes of Health has even awarded more than $11 million in grants to explore social media's role in the prevention and treatment of addiction. The findings are mixed. Critics say online support encourages "unhealthy isolation." Proponents counter that people are less inhibited and reveal more about themselves when no one sees them.

"It's amazing what people will share through digital media that they wouldn't share face to face or even over the phone," said Adam Leventhal, director of the University of Southern California Health, Emotion, and Addiction Laboratory. "Apps and other types of digital media platforms open up a whole new universe of ways to help people quit."

Both the App Store and Google Play are loaded with social apps that aim to help people in recovery. These include I Am Sober, which describes itself as a motivational companion, and Nomo, which tracks days you've stayed straight. Social network Sober Grid connects recovering addicts, while A-CHESS aims to prevent relapses and to make it easy for counselors to reach out to patients. SoberTool shares motivational messages and features a community forum.

These apps are intended to supplement in-person treatments, not replace them, though they can serve people who don't have easy access to those treatments.

Such digital support couldn't come at a more critical time. Opioid abuse has reached crisis proportions in many parts of the country, from the urban centers of New York, Pennsylvania and Illinois to rural West Virginia, which has the highest rate of drug overdoses in the nation. More than 64,000 Americans died from drug overdoses in 2016, according to the Centers for Disease Control and Prevention.

Network effect

Jason Thomas, 37, came across Sober Grid via the App Store in May when he was two weeks into recovery. With two DUIs and failing relationships with family and friends, he wanted to take more control of his actions. And he wanted help doing it.

Each day, Sober Grid reminds members to check in. They record if they're sober, report their current mood and make a daily pledge. If someone gets high, the support network asks what triggered the relapse, and how that person plans to get back on track.  

If members feel a strong urge to drink or take drugs, they can put out a call with the app's "burning desire" function, prompting others to send them motivational messages. Thomas has responded to several of these calls for help.

"Being of service to someone else is going to keep me sober," he said.

Motivational messages are a key part of SoberTool, too.

When you open SoberTool, you're greeted with a list of questions prompting you to think about, and indicate, how you're feeling. One question might ask if you're thinking about relapsing. Clicking on that takes you to follow-up questions like, "Do you feel like using right now?" or "Do you feel worthless?" The app will then display motivational messages like "Be gentle with yourself" or "Don't feel bad about feeling bad."

Mobile perks

Sobriety apps can take advantage of mobile technology in interesting new ways.

A-CHESS, developed by the Center for Health Enhancement Systems Studies at the University of Wisconsin-Madison, uses a GPS tracker to warn recovering alcoholics if they're near a bar they used to frequent, for example. If they don't leave within, say,  five minutes, the app will alert members of their support group.

Dr. Carla Marienfeld, a psychiatrist with UC San Diego Health, is part of a research team working to create a biosensor to detect patients' opioid use. The size of a grain of rice, the sensor would be injected under the skin where it would conduct real-time substance monitoring. An accompanying app would notify physicians or family members when a patient relapses.

Both A-CHESS and the biosensor are especially intriguing because of their nearly instant support.

"You can't be surrounded by human support and treatment 100 percent of the time," Marienfeld said. "An app is a way of providing some level of service when you most need it."

And that may be the best way to look at such sobriety aids: a stopgap when addicts need it most.

"There's no substitute for in-person connection," said Timothy Fong, clinical professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA. "But getting rid of isolation is absolutely necessary."

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