Expanding Nursing Approaches to Address Addiction: Mobile Health Technology.

S ubstance abuse is a leading global health crisis with devastating consequences for individuals, families, and society, including significant morbidity and mortality (World Health Organization, 2016). More than 29 million individuals are estimated to engage in substance abuse, which results in more than 200,000 deaths worldwide each year (European Monitoring Centre for Drugs and Drug Addiction, 2016; United Nations Office on Drugs and Crime, 2016). Globally, substance use is highest among 18to 25-yearolds (World Health Organization, 2016). The prevalence of substance use among young adults (18Y25 years) is 22%, with alcohol being one of the most commonly used substances (Center for Behavioral Health Statistics and Quality, 2015). Substantial consequences result from binge drinking including physical assaults, criminality, sexually transmitted diseases, HIV, unintentional injuries, and deaths (White et al., 2015). Since 2014, the opioid epidemic has resulted in a dramatic rise in overdose-related deaths, up to 369%. Today, most drug overdose deaths involve opioids, with over 90 people dying each day (Centers for Disease Control and Prevention, 2017). The crisis has sent healthcare officials scrambling for means to make sense of the problem and to come up with ways to combat it. One promising approach is the use of mobile health (mHealth) digital technologies. With the explosion of digital technologies, the delivery of healthcare is being transformed. Worldwide, the number of mobile phone users is expected to be more than 5 billion by 2019 (Hopia, Punna, Laitinen, & Latvala, 2015). mHealth is defined as the use of wireless technology to deliver medical care (Fjeldsoe, Marshall, & Miller, 2009; Patrick, Griswold, Raab, & Intille, 2008). mHealth technology is transforming the way society retrieves and exchanges information. The European Commission eHealth Action Plan 2012Y2020 (European Commission, 2012) is a strategic roadmap that provides linkages between mHealth and safer patient-centered health services. According to the European Commission eHealth Action Plan, systematic implementation of mHealth technologies is revolutionizing healthcare delivery in real time (European Commission, 2012). mHealth interventions are becoming increasingly popular in a variety of healthcare settings across diverse cultures and populations (Buhi et al., 2013). These interventions have been used as evidence-based applications by nurses both for clinical treatments (e.g., substance use, medication compliance, chronic conditions) and for public health promotion (Birkhoff & Smeltzer, 2017; Bock et al., 2015; Christie, Dagfinrud, Dale, Schulz, & Hagen, 2014; Cooray, Matusevicius, Wahlgren, & Ahmed, 2015). mHealth technology has also shown much promise as a supportive intervention that bridges the gap between inpatient and outpatient care and specifically as a means of reducing substance use among vulnerable individuals in real-life, real-time contexts (Bock et al., 2015; Kazemi et al., 2017; Mason, Benotsch, Way, Kim, & Snipes, 2014). Given the familiarity and comfort that young adults have with mobile Donna M. Kazemi, PhD, College of Health and Human Services, School of Nursing, University of North Carolina at Charlotte. Maureen J. Levine, PhD, ABPP, Psychology Department, Central Michigan University, Mount Pleasant, MI. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. Correspondence related to content to: Donna M. Kazemi, PhD, College of Health and Human Services, School of Nursing, University of North Carolina at Charlotte, 9201 University City Blvd., CHHS 444C, Charlotte, NC 28223. E-mail: dkazemi@uncc.edu DOI: 10.1097/JAN.0000000000000208 DonnaM.Kazemi,PhD Maureen J. Levine, PhD, ABPP