JMIR Publications

ABSTRACT

Background:

The lockdown measures introduced during the COVID-19 pandemic were a catalyst for rapid digitalisation of services in the field of substance use and substance use disorders. This highlights a need to backcast and co-create a future where digital tools for addressing substance use are optimally developed and used.

Objective:

This paper reports on a backcasting exercise to identify the key values, challenges, facilitators and milestones in achieving this future by 2030.

Methods:

A backcasting exercise methodology was adopted that built on the work of López-Pelayo et al., (2021). A project Open Science Framework page was used as an online collaborative working space. Key stakeholders were invited, consulted and engaged at the 2022 Lisbon Addiction Conference to collaboratively determine the current scenario, desired future scenario, key Values, Challenges, Facilitators, Cornerstones and Milestones.

Results:

Key Values identified included: Digital Rights; Evidence-based digital solutions; User-friendly; Access/Availability and Person-Centred. Key Challenges identified included: Funding; Regulations; Commercialisation; Lack of best practice standards and Digital literacy, access and reach. Key Facilitators identified included: Scientific theory and infrastructure; Expertise; Ethical funding; User-friendly design and Digital rights and regulations. Milestones and Cornerstones included: Ethical Frameworks, Monitoring and Evaluation and Continuous Trend Analysis.

Conclusions:

The use of digital tools in the fields of substance use and substance use disorders may be linked to a range of risks and opportunities that need to be managed. Current trajectories of use of such tools are heavily influenced by large multinational for profit companies with relatively little involvement of key stakeholders such as people who use drugs, service providers and academics. Current funding models are problematic and lack the necessary flexibility associated with best practice business approaches such as Lean, AGILE and customer discovery. Access/availability, digital rights, user friendly design and person-focused approaches should be at the forefront of efforts to develop this space. Global legislative and technical infrastructures are necessary and should include ethical frameworks, monitoring and evaluation and continuous trend analysis.