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Cognitive Technology for Addiction-It's Time for Action

Thomas Morrow, MD, is the chief medical officer for Next IT. His current position is the culmination of his passion to improve clinical outcomes for people with chronic disease through the use advanced natural language processing and artificial intelligence. He graduated from Thomas Jefferson Medical College in Philadelphia, practiced family medicine for 14 years, and held a variety of positions including a faculty position at a residency and medical school, staff physician at a staff model health maintenance organization, and numerous medical director positions at multiple health plans.
The 2015 US federal budget includes $27 billion targeted for drug control. This amount does not take into account about another $25 billion in other related costs. Think about this: 1.5 million people are arrested each year;  approximately 345,000 people infected by HIV due to needle sharing; and approximately 2,220,300 people in prison or local jails.
The statistics demonstrate only the economic costs. Other costs include the damage done to families, children, and marriages, the loss of jobs, lost productivity, accidents, the list goes on and on. Addiction is very expensive indeed.
There are a wide variety of addicts including approximately 17 million people in the US with alcohol use disorder and many millions more addicted to a variety of drug classes. More broadly, addiction also includes about 42 million smokers.
Relapse is the Hallmark of Addiction
One of the hallmarks of drug addiction is the relapse rate. For some reason, our medical delivery system treats addiction like a hernia repair: intervene and it’s fixed. But it isn’t. Addiction-related recidivism is high for a number of reasons including, of course, the addictive nature of substances. But recidivism is also associated with a lack of insurance coverage as well as an absolute deficit of trained professionals capable of helping with addiction.

Other barriers include the personal reasons for people to not seek treatment such as stigma and embarrassment, as well as a desire to try to tackle this complex behavior change on their own. 
Cognitive Technologies Offer a Proven Option
Numerous studies have been done on how to stretch precious human resources using cognitive technologies.  One, written by John Cunningham et al, entitled The Use of Emerging Technologies in Alcohol Treatment described a number of internet-based interventions and divided them into 3 groups:
  1. Screening Tools
  2. Cognitive Behavior Treatment Programs
  3. Emerging Technologies

There are several screening tools available. Many are included by the Substance Abuse and Mental Health Services Administration, a government agency dedicated to improving health.   
These screening tools can be used in a variety of age groups and include scoring processes. Many have demonstrated efficacy in not only improving screening but also in actually changing drinking behavior.
Internet-based cognitive behavior treatment programs also have proven efficacy for addiction treatment. These include functions such as text messaging as well as online teaching and counseling. 
Online support groups also can be used to assist with alcoholism. Alcoholics Anonymous and Moderation Management have proven efficacy in a variety of populations.

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