According to the 2020 National Survey on Drug Use and Health, 40.3 million Americans aged 12 or older had a substance use disorder (SUD) in the past year.1 And SUDs in the workplace have reached a crisis point in the U.S., costing billions in direct medical costs and related productivity impacts.
New research from the Centers for Disease Control and Prevention (CDC) has found that the annual minimum direct cost of SUDs for employers is $35 billion annually, or $15,640 per affected employee enrolled in employer-sponsored insurance.2 This does not include productivity-related costs exceeding $250 billion annually and workers with alcohol use disorder missing more than 232 million work days annually.3,4 Alcohol use disorder (AUD) at $10.2 billion annually was the single costliest SUD according to the study.
Since the COVID-19 pandemic, alcohol consumption in the U.S. has increased by 25%, which, if sustained for even one year, is estimated to cause over 18,000 new cases of liver failure and 8,000 additional deaths from liver disease.5 Unfortunately, many suffering won’t seek help, with studies showing that only 1 in 10 people with a substance use disorder gets treatment.6
Because of this, Quit Genius is working on innovative new approaches to treating alcohol use disorder, in particular through substance use management supported with virtual care and medication-assisted treatment.
Quit Genius, the world’s first digital clinic for treating multiple substance addictions recently discussed results from a pilot study of integrated AUD treatment. Published in Telemedicine Reports, the trial looked at the feasibility, acceptability, and preliminary outcomes of a virtual intervention combining cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET) plus naltrexone for individuals with AUD.8,9
Naltrexone is an FDA-approved medication that blocks opioid receptors in the brain to help reduce dependence on alcohol and opioids. The authors found that integrated digital health treatment of AUD combining evidence-based psychosocial and pharmacological treatment is feasible and may produce improvements in both alcohol use and psychiatric symptoms.
Suzette Glasner, Ph.D., Vice President of Clinical Affairs at Quit Genius and lead author of the study, said new, innovative approaches to AUD are needed to address significant barriers to care. These barriers include poor access to evidence-based care, social stigma, lack of motivation to change, and cost of treatment.
“We know from research that less than 11% of individuals who are in need of treatment for substance use disorders actually receive treatment, and a large proportion of those who fail to engage do so because of limited access to care,” explained Glasner. “Moreover, in recent years, only 16% of specialty treatment programs offered any single medication for alcohol use disorder treatment. Though we are gradually seeing improvement as awareness of the efficacy of medications for alcohol and other substance use disorders increases, the greatest advancement that our pilot study offers is the capacity to expand access to underutilized and well-studied, efficacious treatments for alcohol use disorders.”
Although this was a small pilot study, reductions in alcohol use and improvement in health were encouraging, with a fully powered randomized controlled trial (RCT) now underway. Engagement and completion rates were promising, and significant decreases in alcohol consumption were reported. Furthermore, even though the Quit Genius alcohol intervention content did not address psychiatric symptoms directly, reductions in depression and anxiety were reported along with increased resiliency.
Adults with AUD (N = 26) were recruited through online, social media-based advertising and enrolled in a 12-week, integrated telemedicine intervention that combined psychosocial treatment with medical management using the Quit Genius virtual alcohol program. Feasibility, acceptability, perceived helpfulness, treatment engagement, retention, completion, and clinical outcomes—including alcohol use and secondary mental health outcomes—were assessed.
Primary outcomes were the proportion of days abstinent and drinks per drinking day. The proportion of days abstinent in the past 30 increased from 13.8% to 59%, and more than two-thirds (68%) of study subjects reduced their alcohol use by one or more WHO risk drinking levels.10 Depressive symptoms were reduced from moderately severe at baseline to the mild range, and anxiety severity declined from moderate to the mild range.
Overall, participants found the Quit Genius virtual intervention to be acceptable and helpful in facilitating action toward their therapeutic goals concerning alcohol use.
Considering the low rates of AUD treatment and the troubling rise in alcohol use associated with the COVID-19 pandemic, study authors believe that innovations in telemedicine and m-health (use of mobile phones and other hand-held devices) “have the potential to be transformative, expanding access to evidence-based therapies.”
The authors also cite several professional health organizations and national agencies that recommend using telemedicine to expand the availability of qualified addiction medicine providers, particularly among populations with limited access to specialty treatment.
Although AUD populations are often difficult to engage and retain in care, preliminary evidence gathered in this study suggests that an m-health approach can overcome these challenges. Although recent efforts to expand telemedicine for addictions have concentrated on medications for opioid use disorders, the findings from this study suggest that broadening access to evidence-based behavioral and pharmacological treatment for AUD through telehealth is feasible and potentially effective.
The Quit Genius substance use management alcohol program takes an evidence-based approach that combines technology, medication, and qualified professionals to address the high cost of AUD in the workplace, including absenteeism, health complications, injuries, and other losses in productivity. Within the first 30 days of care, Quit Genius program members see a 62% reduction in alcohol use frequency, and 80% of enrolled participants reduce alcohol use frequency by 30% or more.
Quit Genius integrates with health plans, pharmacy benefit managers, and wellness platforms to deliver a turnkey implementation experience. Quit Genius recently partnered with pharmacy benefit manager Evernorth and B2B health insurance company Evry Health to make its tobacco, alcohol, and opioid addiction solutions available to members. Visit quitgenius.com for more information.
7. Glasner, Webb, Michero,et al. Telemedicine Reports. Feasibility, Acceptability, and Preliminary Outcomes of an Integrated Telemedicine Intervention Combining Naltrexone and Cognitive Behavioral Therapy for Alcohol Use Disorder
10. U.S. Food & Drug Administration Critical Path Innovation Meeting November 09, 2018. A Reduction in the World Health Organization (WHO) Risk Levels of Alcohol Consumption as an Efficacy Outcome in Alcohol Use Disorder (AUD) Clinical Trials. Compiled by National Institute on Alcohol Abuse and Alcoholism (NIAAA).