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Peer-reviewedCC BY-NC 4.0The American Journal on Addictions

Clinical applications of wearable devices for individuals with at‐risk substance use and substance use disorders: A systematic review

  • Alexandra Sas1,2,3,4
  • Matthew E. Sloan1,3,4,5,6,7,8
  • Yaoyi Xing9
  • Ethan Kim10
  • Dhvani Mehta1,2,3,4
  • Anna Mouzenian1,3,4
  • Lena C. Quilty5,8
  • Jeffrey D. Wardell4,5,11
  • Shannon Lange1,3,4,5
  • Daniel Felsky10
  • Victor M. Tang1,2,3,4,5
11 affiliations
  1. 1Institute of Medical Sciences, Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
  2. 2INTREPID Lab Centre for Addiction and Mental Health Toronto Ontario Canada
  3. 3Institute for Mental Health Policy Research Centre for Addiction and Mental Health Toronto Ontario Canada
  4. 4Addiction Division Centre for Addiction and Mental Health Toronto Ontario Canada
  5. 5Department of Psychiatry, Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
  6. 6Department of Psychological Clinical Science University of Toronto Scarborough Toronto Ontario Canada
  7. 7Department of Pharmacology & Toxicology University of Toronto Toronto Ontario Canada
  8. 8Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
  9. 9Cornell University Ithaca New York USA
  10. 10Krembil Centre for Neuroinformatics Centre for Addiction and Mental Health Toronto Ontario Canada
  11. 11Department of Psychology, Faculty of Health York University Toronto Ontario Canada
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Abstract

Background and Objectives: Managing substance use disorders (SUDs) is limited by the lack of longitudinal clinical data during active use and recovery. Wearable devices may help address this gap by capturing physiological and behavioral data in real‐world settings. This review evaluated the feasibility and acceptability of wearable devices among individuals with SUDs.

Methods: A systematic search of PubMed, PsycINFO, and MEDLINE identified peer‐reviewed studies published between 2000 and 2023 examining wearable devices that passively measured physiological data among adults with SUDs or at‐risk substance use.

Results: Thirty‐three studies met inclusion criteria and were grouped into feasibility and acceptability outcomes, sleep‐related outcomes, and other clinical outcomes including craving, stress, and detection of substance use or overdose events. Most studies used wrist‐worn devices and focused on opioid and alcohol use. The literature was heterogeneous and predominantly observational, with few experimental designs, and several studies included individuals with at‐risk use rather than diagnosed SUDs. Short‐term wearable use was generally feasible and acceptable when privacy and safety concerns were addressed. Wearables captured indicators such as sleep disruption, stress, and overdose risk. However, none of the included studies evaluated whether wearable use was associated with improved substance use outcomes over time.

Discussion and Conclusions: Wearable devices show promise as adjunct tools for monitoring clinically relevant indicators in SUDs, but evidence remains limited. Future research should prioritize longitudinal outcomes, validate clinically meaningful thresholds, and support equitable, patient‐centered implementation.

Scientific Significance: This review provides a structured synthesis of an emerging and fragmented literature, offering a foundation to guide future hypothesis‐driven, longitudinal, and implementation‐focused research.

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Cite

BibTeXRIS
BibTeX
@article{sas2026clinical,
  title = {{Clinical applications of wearable devices for individuals with at‐risk substance use and substance use disorders: A systematic review}},
  author = {Alexandra Sas and Matthew E. Sloan and Yaoyi Xing and Ethan Kim and Dhvani Mehta and Anna Mouzenian and Lena C. Quilty and Jeffrey D. Wardell and Shannon Lange and Daniel Felsky and Victor M. Tang},
  journal = {The American Journal on Addictions},
  year = {2026},
  month = sep,
  doi = {10.1111/ajad.70199},
  url = {https://doi.org/10.1111/ajad.70199},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Clinical applications of wearable devices for individuals with at‐risk substance use and substance use disorders: A systematic review
AU  - Alexandra Sas
AU  - Matthew E. Sloan
AU  - Yaoyi Xing
AU  - Ethan Kim
AU  - Dhvani Mehta
AU  - Anna Mouzenian
AU  - Lena C. Quilty
AU  - Jeffrey D. Wardell
AU  - Shannon Lange
AU  - Daniel Felsky
AU  - Victor M. Tang
PY  - 2026
DA  - 2026/09/09
JO  - The American Journal on Addictions
DO  - 10.1111/ajad.70199
UR  - https://doi.org/10.1111/ajad.70199
AB  - Background and Objectives: Managing substance use disorders (SUDs) is limited by the lack of longitudinal clinical data during active use and recovery. Wearable devices may help address this gap by capturing physiological and behavioral data in real‐world settings. This review evaluated the feasibility and acceptability of wearable devices among individuals with SUDs.  Methods: A systematic search of PubMed, PsycINFO, and MEDLINE identified peer‐reviewed studies published between 2000 and 2023 examining wearable devices that passively measured physiological data among adults with SUDs or at‐risk substance use.  Results: Thirty‐three studies met inclusion criteria and were grouped into feasibility and acceptability outcomes, sleep‐related outcomes, and other clinical outcomes including craving, stress, and detection of substance use or overdose events. Most studies used wrist‐worn devices and focused on opioid and alcohol use. The literature was heterogeneous and predominantly observational, with few experimental designs, and several studies included individuals with at‐risk use rather than diagnosed SUDs. Short‐term wearable use was generally feasible and acceptable when privacy and safety concerns were addressed. Wearables captured indicators such as sleep disruption, stress, and overdose risk. However, none of the included studies evaluated whether wearable use was associated with improved substance use outcomes over time.  Discussion and Conclusions: Wearable devices show promise as adjunct tools for monitoring clinically relevant indicators in SUDs, but evidence remains limited. Future research should prioritize longitudinal outcomes, validate clinically meaningful thresholds, and support equitable, patient‐centered implementation.  Scientific Significance: This review provides a structured synthesis of an emerging and fragmented literature, offering a foundation to guide future hypothesis‐driven, longitudinal, and implementation‐focused research.
SN  - 1055-0496
SN  - 1521-0391
ER  -