Kristen Muhlner, CEO of Affect Therapeutics, shares her vision for the future of addiction treatment and the role digital tools will play in shaping it.
Addiction is an urgent global issue that affects millions worldwide.
In the US, drug overdose rates have reached record levels as the opioid epidemic continues to lay waste to the lives of people across the country.
Meanwhile, traditional treatment methods are failing to keep up with the rising numbers of people suffering from substance misuse.
It is estimated that 46 million Americans meet the criteria for having a substance use disorder.
However, only 10 per cent receive any form of treatment, most commonly due to structural barriers such as financial costs or access to programmes.
One of the most significant challenges faced by the healthcare system is the scarcity of licensed psychiatrists and counsellors equipped to handle the growing demand for addiction treatment.
Traditional treatment methods often rely on one-to-one approaches, limiting the reach and accessibility of care.
Digital health and telemedicine are emerging as promising solutions to filling a huge void in the addiction treatment landscape.
Affect Therapeutics is among the first companies to offer a digital, clinically intensive treatment built on scientific research.
The company recently announced a $16 million Series A funding round to develop expand its programme across the US and develop new
“The broad issue that we have globally is a dearth of licensed psychiatrists and counsellors,” said Kristin Muhlner, CEO of Affect Therapeutics.
“In the medium to long term, the opportunity with digital treatment programmes is to leverage technology to get more scale and move away from the current one-to-one approach.”
Right now, digital tools are yet to be widely adopted in addiction treatment.
Founded in 2020, Affect Therapeutics is the first integrated all-digital addiction recovery programme to be made available to patients.
The programme marries cognitive behavioural therapy with counselling, medical oversight and case management.
Members of the Affect platform receive rewards for success in treatment, including engagement and provision of negative drug and alcohol screens.
In its short time in market, Affect has treated thousands of patients with results that are proven to be twice as effective as traditional treatment models, benchmarked against HEDIS data.
According to Muhlner, generative AI is likely to play an increasing role as tools such as Affect develop.
She also expects that telehealth will also allow for greater resource fungibility across regions, giving individuals in underserved areas access to qualified addiction professionals.
“A lot of the future direction and innovation is really going to be in service to this issue of simply not having enough trained people to serve the need,” Muhlner said.
“Mental health and substance use disorders are the number one issue facing every locality in the [US] today.
“It’s under-resourced and underfunded. The [adoption] of technology in healthcare has been unbelievably slow.
It’s a huge time for embracing technology as a means to try to enable more access to care.”
Shaking off the stigma
Stigma remains one of the central reasons why nine in ten patients do not seek out treatment for their addiction issues.
“They might be afraid of what other people will think, afraid of the social judgement, and certainly afraid of having to show up someplace and be around other people and admit they have an issue,” Muhlner said.
Affect believes a digital treatment programme helps tackle the stigma, or at least sidesteps it, by bringing the treatment to people in the place they’re most comfortable.
“It lowers that kind of innate fear, right off the bat because it feels safer,” Muhlenr added.
“You can do this from your house and you’ve got a little bit of a shield.”
Aside from stigma, some patients may avoid treatment simply because they are not ready, but Affect allows the individual to face their issues in their own time.
The app can be downloaded for free, giving users access to certain content explaining the science and neurology behind addiction, along with inspirational messages.
According to Muhlner, it may be months or years before they are ready to fully engage with the platform.
“We support people through the entirety of their journey, from pre-contemplation all the way through to recovery,” she said.
“Often, if people relapse or disengage in treatment, they’ll come back around. We are that continuous lifeline.”
Leveraging the power of data and gamification
At the heart of Affect’s approach lies a data-driven methodology that shapes personalised treatment plans for users.
The platform collects a wealth of data from its users, asking about cravings, anxiety, depression and personal goals.
This provides counsellors with crucial context before every interaction, helping them give more precise and relevant care.
It also allows for early intervention if a serious adverse event occurs.
“That’s a fairly basic use case, but it’s a very important one because it helps really drive pretty intense efficiency in those interactions,” Muhlner said.
“It has dramatically impacted our quality measures.”
“We’re capturing thousands of data points about people that have never been gathered before in a structured way,” she added.
“This is really important as we look at how to drive population-level insights over time.”
Aside from the traditional treatment types offered through the app – including group and individual therapy – Affect has adopted concepts of gamification to keep users engaged and motivated.
Inspired by the structure of video games, the app invites users to embark on missions and challenges which come with rewards for healthy behaviour along with small financial incentives.
“What we’re trying to do is create a goal around some series of longitudinal activities that are going to be beneficial,” Muhlner said.
“When we do that and we reward those things, the member achieves a positive outcome.”
Breaking down societal barriers to addiction treatment
Addiction is prevalent across all socioeconomic statuses, but those in vulnerable positions, characterised by insecure housing, unstable income and lack of access to healthcare services, are at particular risk.
Central to Affect’s model is making treatment accessible and affordable.
The majority of its members are among the third of American citizens covered under a Federal Medical Insurance Programme, Medicaid.
These insurance programmes typically have poor access to high-quality substance use disorder care, “in part because the reimbursement rates are low,” Muhlner said.
“And in part because of a historic unwillingness on the part of the federal government and states to adequately fund this area.”
Numerous studies have highlighted a correlation between social isolation and addiction.
Understanding the challenge of loneliness and disconnection that individuals in recovery face, Affect fosters an environment where users can connect with peers, share experiences, and build a support network that extends beyond the digital realm.
“We facilitate our members’ ability to connect with one another outside of formal counselling sessions through online group capabilities,” Kristen Muhlner explains.
Affect actively encourages users to participate in in-person community groups like AA or NA, recognizing the significance of face-to-face connections in the recovery process.
Treating the disease, not just the symptom
Addiction is complex. Underlying issues like income inequity, lack of availability to adequate healthcare and other systemic problems run beneath the surface of many patients in recovery.
In a lot of cases, simply getting clean isn’t enough.
Affect aims to address these issues within the platform’s framework.
Members are offered resources and support for employment, housing and healthcare to reduce the risk of relapse after completing the programme.
“We don’t just deal with treating the substance use disorder but also help stabilise the individual and improve their life overall,” Muhlner said.
Historically, addiction psychiatry has taken an all-or-nothing approach to recovery. Absolute sobriety was the goal.
Patients who relapsed were often kicked out of their programme for their mistake.
“We didn’t treat addiction as the chronic disease that it is,” Muhlner said.
“We treated people as if we could put them in a washing machine and get them clean and send them on their way.”
Now, the field has shifted towards harm reduction, increasing the number of sober days and celebrating the small wins.
Affect leaves the ultimate goal up to the individual, whether that is figuring out how to manage moderation or working towards complete sobriety.
Both options are accepted and celebrated.
“It is better to support the goals and the milestones that each individual has and celebrate those, whatever they are,” Mulhner added.
“Eventually people come to the place that’s right for them.
“This approach is such a breath of fresh air for so many people.”