Abstract
Biosensors enable observation and understanding of latent physiological occurrences otherwise unknown or invasively detected. Wearable biosensors monitoring physiological constructs across a wide variety of mental and physical health conditions have become an important trend in innovative research methodologies. Within substance use research, explorations of biosensor technology commonly focus on identifying physiological indicators of intoxication to increase understanding of addiction etiology and to inform treatment recommendations. In this review, we examine the state of research in this area as it pertains to treatment of alcohol use disorders specifically highlighting the gaps in our current knowledge with recommendations for future research. Annually, alcohol use disorders affect approximately 15 million individuals. A primary focus of existing wearable technology-based research among people with alcohol use disorders is identifying alcohol intoxication. A large benefit of wearable biosensors for this purpose is they provide continuous readings in a passive manner compared with the gold standard measure of blood alcohol content (BAC) traditionally measured intermittently by breathalyzer or blood draw. There are two primary means of measuring intoxication with biosensors: gait and sweat. Gait changes have been measured via smart sensors placed on the wrist, in the shoe, and mobile device sensors in smart phones. Sweat measured by transdermal biosensors detects the presence of alcohol in the blood stream correlating to BAC. Transdermal biosensors have been designed in tattoos/skin patches, shirts, and most commonly, devices worn on the ankle or wrist. Transdermal devices were initially developed to help monitor court-ordered sobriety among offenders with alcohol use disorder. These devices now prove most useful in continuously tracking consumption throughout clinical trials for behavioral treatment modalities. More recent research has started exploring the uses for physical activity trackers and physiological arousal sensors to guide behavioral interventions for relapse prevention. While research has begun to demonstrate wearable devices' utility in reducing alcohol consumption among individuals aiming to cutdown on their drinking, monitoring sustained abstinence in studies exploring contingency management for alcohol use disorders, and facilitating engagement in activity-based treatment interventions, their full potential to further aid in understanding of, and treatment for, alcohol use disorders has yet to be explored.
Highlights
In the United States, each year, alcohol use disorders (AUD) affect roughly 15 million individuals and cost nearly $250 billion in treatment and economic losses [1, 2]
Most participants reported neutral comfort with the bracelet, denied the bracelet interfered with their mood, sleep, work, and normal activities, and believed the bracelet helped them reduce their drinking. These findings indicate that Secure Continuous Remote Alcohol Monitor (SCRAM R) may be feasibly incorporated into outpatient treatment of AUD
In addition to wearable devices explicitly designed for alcohol use, researchers have begun using biosensors originally developed for other purposes to improve treatments of alcohol use disorder
Summary
In the United States, each year, alcohol use disorders (AUD) affect roughly 15 million individuals and cost nearly $250 billion in treatment and economic losses [1, 2]. In AUD biosensor research literature, devices tested fall into two categories: [1] those designed to detect alcohol use (e.g., identifying intoxication) and [2] those designed for primarily other purposes (e.g., physical activity) but are being explored in specific use cases related to alcohol. The former has a significantly larger body of literature, with most research over the past 20 years centering on creating and refining biosensors to detect intoxication in laboratory and field-testing environments [10,11,12,13].
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