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Wearable Technologies as a Tool for Alcohol Assessment and Intervention

Use of wearable technologies to understand substance use behaviors has been gaining traction in the field of substance use, both as it relates to patterns of use and as a tool for intervention. Broadly, wearable technologies employ biosensors, usually as a device that can be worn around the wrist or ankle. The biosensors track physiological data that correspond to outcomes such as alcohol intoxication.

Two primary metrics are used to assess intoxication via biosensors. First, gait is used to assess changes in locomotion that have been found to correspond with alcohol intoxication. Second, sweat readings are used to assess the presence of alcohol in the blood stream. These values can then be converted to BAC estimates. Supplementary metrics include heart rate variability and skin temperature changes. The main advantage of this technology is the ability to capture continuous real-time data, as opposed to other biometrics such as breathalyzers that capture data at a specific point in time. In a review of this technology, Davis-Martin et al. (2022) discuss the utility and state of research on using wearable biosensors in alcohol use disorder treatment. For example, contingency management interventions can benefit greatly from use of wearable biosensors for alcohol use, as it is often difficult to accurately assess use between sessions, such as having treatment require participants to complete several breath tests per day. Wearable biosensors allow for continuous tracking with minimal participant burden.

Two pilot studies on use of this technology in contingency management have found mixed support, suggesting some potential but also the need for better understanding of how to effectively integrate biosensors. In a feasibility study of biosensors in community-based AUD services that included 12-step, relapse prevention, and group therapy approaches, participants reported that the wearable biosensors were not interfering with daily life, suggesting this technology is acceptable to people in treatment for AUD. As research in this area grows, new avenues are being considered. For example, in addition to physiological markers, some wearable technologies have GPS capabilities to track where alcohol use behaviors occur or presence in a location where alcohol is often purchased or consumed, such as a liquor store or bar. This feature could aid in the development of just-in-time interventions, where participants receive tools via smartphone applications when their GPS indicates they are in a location with increased risk of alcohol consumption. Although the majority of available research to date has distribute biosensors through research or treatment teams, technological advances could enable individuals to use personal fitness trackers. This would make wearable technology more accessible for research and clinical practice. Additionally, use of fitness trackers will allow integration of substance use goals with other health goals, including sleep and physical activity, that can be tracked simultaneously with alcohol use behavior. The 11th annual meeting of  Collaborative Perspectives on Addiction [PN1] (CPA), hosted by APA Division 50 in March 2023, has included wearable technologies in their call for symposium presentations. Use of this methodology is part of the symposiums theme “reaching new frontiers in addiction science: bridging the gap to treatment,” highlighting a broader initiative by APA division 50 to include technology in our understanding of behavior and treatment.

Source: Davis-Martin, R. E., Alessi, S. M., & Boudreaux, E. D. (2021). Alcohol use disorder in the age of technology: A review of wearable biosensors in alcohol use disorder treatment. Frontiers in Psychiatry, 12, 642813. doi: 10.3389/fpsyt.2021.642813[PN2] .

 [PN1]Link is embedded here https://addictionpsychology.org/cpa

 [PN2]Link is embedded here https://www.frontiersin.org/articles/10.3389/fpsyt.2021.642813/full