Missourians struggling with a substance use disorder while lacking stable housing were 50% less likely to use an illicit drug within 30 days thanks to a specialized free app.
That's according to a Washington University School of Medicine study.
"Anybody and everybody can be affected by addiction," said Dr. Vidya Eswaran, the study's lead author and an assistant professor of emergency medicine at Washington University School of Medicine. "We're all probably a little closer to ending up homeless than we would like to believe. I really encourage people to think about how we can support this population, especially in kind of low-barrier access to care."
In 2018, a team at Washington University's School of Medicine launched the uMAT-R app to improve recovery odds while making it accessible to the state's most vulnerable population. St. Louis Public Radio's Marissanne Lewis-Thompson spoke with Eswaran about how the app is removing cost barriers and taking a holistic approach to recovery.
This interview was edited for clarity and length.
Marissanne Lewis-Thompson: What is the uMAT-R app?
Dr. Vidya Eswaran: There are resources within the app if you need housing assistance or you need to find a job or are looking for food [or] shelter. There are local resources within the app. There's also educational modules. The name uMAT-R comes from the abbreviation MAT, which is for medication-assisted treatment, which is the gold standard best evidence-based treatment for substance use disorders. I think the coolest thing about the app is that there's actually the opportunity to engage with a real human being through the app that's our health coach.
Lewis-Thompson: This study focuses on the challenges people with a substance use disorder face when they don't have stable housing. What is it about the uMAT-R app that encourages people to use it as a tool to aid in their recovery?
Eswaran: One is recognizing that it's not just the medicine that people need, but the app really thinks about the whole person and has the resources for everything else. If you don't have food, how are you going to make it to your doctor's appointment to get your medication? If you don't have a job, how are you going to be able to pay the co-pay for your doctor? And so, recognizing that it's not just the medicine, but everything else in a person's life that impacts their health and wellbeing. Those resources are within the app. I think the other thing that people really appreciate is the ability to interact with somebody in real-time through the app. It's a real person who they can talk to and can give them that individualized support that they need.
Lewis-Thompson: Cost remains a barrier to treatment. For some in-patient treatment facilities, the cost for a 30-day stint is a person's salary. How is the uMAT-R app easing that burden?
Eswaran: The app is free for folks who are using it. All of our funding is through the Missouri Department of Mental Health. We've been getting over seven years of funding from them to be able to provide this free of charge to folks in Missouri. And so you get access to all of those resources I talked about before for free.
Lewis-Thompson: There are people in those facilities who are using this app. Is there a consistent pattern that shows people with a substance use disorder are able to stay clean longer?
Eswaran: Currently, we've been studying 30-day outcomes. So from using the app [for] 30 days. We have found significant reductions in use. So people who use the app and engage with it were found to have 50% fewer odds of reporting using illicit substances within a month. And so we'd love to take this study out longer and see longer-term impacts. But that first 30 days is really crucial too. Thirty days is a long time to not be using substances for folks who have a substance use disorder.
Lewis-Thompson: This app is called uMAT-R. For you, why does this particular project matter?
Eswaran: I'm an ER doctor. I work at Barnes as one of my hospitals. Every day I see patients who are in one way or another affected by substance use disorder. Even just last night I was working in the ER and there was a woman who came in who was talking about how she really needed help for her substance use disorder. She had been on therapy before. Fell off the wagon [and] was using again. [She] knew what she needed, but didn't know how to get there. [She] needed that support to really live her best life and she was telling me about how when she was on treatment and getting treated and not using how she was able to hold a job. How she was able to go to church. How she was able to take care and have custody of her kids and really have a full meaningful life. We have the treatment. We have treatment in medications to help people get there. It's the access that's missing.
Missourians interested in using the free uMAT-R app are encouraged to call 314-944-2464 or email behealthy@wustl.edu.
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