Hampton J, Mugambi P, Caggiano E, et al. Closing the Digital Divide in Interventions for Substance Use Disorder. J Psychiatr Brain Sci. 2024;9(1)doi:10.20900/jpbs.20240002
This review provides information about the current landscape of inequities in substance use disorder (SUD) treatment. The authors focus on the existing digital divide and how social determinants of health (SDoH) drive digital inequalities. In general, the use and acceptability of digital tools in healthcare practice is on the rise. Despite the promise of digital health tool’s ability to mitigate barriers to treatment for SUD, a lack of appropriate planning and design may result in increased barriers to care. The authors discussed four barriers related to SDoH: Broadband access, digital device access, privacy and cultural concerns, and digital literacy. While a lack of access to good wi-fi and a device capable of running novel applications and web portals are important to consider. It is also crucial not to overlook end users’ discomfort with geolocation, confidentiality concerns, and fear of legal or social persecution. In addition, potential generational and educational disparities can lead to digital literacy concerns. The use of algorithms in digital tool development also may promote biases and should be used with caution. Researchers and developers should make all possible efforts to avoid introducing bias into algorithms used in the development or back-end of digital therapeutics for SUD. In addition, the authors suggest increasing programs to expand high-speed broadband and smartphone access and making controversial aspects of applications, like geolocation, optional. Overall, this review provides support for digital interventions for SUD and provides cautious optimism for using these tools to decrease the inequalities in SUD treatment, given proper consideration for digital health disparities.