Coronavirus (COVID-19) had disrupted the substance use disorder (SUD) treatment system, demanding an abrupt shift from in-person care to telehealth services. The transition to virtual care could have permanently changed SUD treatment delivery. This shift had coincided with COVID-19-induced social isolation and anxiety, which could have increased substance use and mental health disorder severity.

A common refrain in the treatment and recovery field had been that addiction is a disease of isolation; the cure is connection. To provide virtual treatment and the connection essential to recovery, many SUD treatment centers had launched virtual services without a method for assessing how, where, and why virtual services had affected their patients' quality of life and SUD recovery. The ACHESS smartphone app had been used at 40 Iowa treatment sites in the parent study, “Test of a patient-centered e-health intervention in addiction treatment settings.” ACHESS had offered a guide and a method for assessing the use of virtual services and an unprecedented research opportunity. From 3/3/20 to 3/20/20, sign-ups for ACHESS in the parent study had increased by 67% compared to the two prior weeks. Activity on the ACHESS app had nearly doubled in the same period.

This supplement had addressed patient and organizational factors because of their integral roles in providing virtual care and adopting patient-centered technologies. The supplement had enhanced ACHESS with new COVID-19-related features designed to help patients comply with social distancing guidelines, cope with unprecedented social isolation, and access virtual services and supports. The research had studied how patients used ACHESS features, how organizations referred patients to ACHESS, how they interacted with patients in ACHESS, and the overall impact of the ACHESS features.