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Substance use and behavioural addiction disorders affect tens of millions of people globally, carry economic costs running into the hundreds of billions annually, and have well-established clinical pathways for treatment. Even with a comparable burden, they capture only a marginal share of the investment flowing into diabetes and mental health technology.

The mismatch is not about a lack of evidence for what works. It鈥檚 about something more systemic: how investors price risk in categories they find difficult to measure, how health systems commission services for conditions they still partly treat as social problems rather than medical ones, and how addiction has historically sat in a regulatory and reimbursement grey zone that makes returns harder to model.

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The Systemic Hurdles Holding This Category Back

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Emily Bargabos, Co-Founder and CEO of Steady, a platform focused on reducing stigma and building recovery support networks, frames the investment gap in part as a measurement problem. The sector lacks the kind of clear technological breakthrough that has transformed other chronic conditions 鈥� there鈥檚 no single intervention that works reliably across populations. There鈥檚 no equivalent of insulin here 鈥� recovery tends to involve different combinations of treatment, medication, peer networks and social support for different people, and what works for one person may not work for another.

鈥淭his complexity may be one reason the category has attracted less investment than it deserves,鈥� she says. 鈥淎ddiction is difficult to measure, difficult to study and difficult to fit into traditional healthcare models 鈥� but that should be viewed as an argument for more innovation, not less.鈥�

The economic case is straightforward even if the clinical picture is nuanced. Untreated substance use disorders in the US alone cost more than $400 billion annually, according to Bargabos, citing published research. Substance use disorder treatment saves an estimated $7 for every $1 spent by reducing healthcare utilisation, legal costs and lost productivity. 鈥淩educing stigma is not simply a social good,鈥� she says. 鈥淚t is an economic imperative.鈥�

Mark Astor, founder of Astor Simovitch Law and a specialist in behavioural health legal practice, sees the same dynamic from a different angle. 鈥淎ddiction is still treated as a social problem rather than a chronic medical condition. Stigma continues to influence investment decisions, healthcare commissioning, reimbursement models and public policy.鈥� He offers a more candid assessment of why this gap exists: 鈥淎ddiction is one of the few healthcare conditions where failure to invest costs more than investment itself.鈥�

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What Effective Digital Addiction Support Looks Like

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The conversation about addiction technology is frequently conflated with consumer wellness apps, which is part of why the investment case has been poorly understood. The tools with credible evidence behind them look different.

Saravanan Thangarajan, Visiting Scientist at Harvard T.H. Chan School of Public Health and Ariadne Labs, draws a clear line between what works and what doesn鈥檛. 鈥淐linically useful addiction technology should not look like another wellness app,鈥� he says. 鈥淭he credible models are those that extend evidence-based care: cognitive behavioural therapy, contingency management, medication-assisted treatment support, motivational engagement, peer recovery coaching and rapid follow-up during high-risk periods. The technology matters only when it keeps the person connected to treatment, trust and timely human support.鈥�

His most important observation is about where the care pathway breaks down. 鈥淭he biggest risk is not relapse. It鈥檚 disappearance 鈥� the moment a person leaves detox, an emergency department, a counselling session or a crisis call and falls out of the care pathway.鈥� He argues the real investment gap isn鈥檛 at the front door of treatment, but in everything that happens afterward.

Astor echoes this from his work with families in treatment. 鈥淥ne of the greatest misconceptions in addiction care is that access to treatment is the problem. Retention, accountability and long-term engagement are the real challenges. Technology is uniquely positioned to address those gaps.鈥� The most effective platforms he鈥檚 seen combine telehealth, recovery coaching, family engagement, medication adherence tools, relapse monitoring, digital cognitive behavioural therapy and predictive analytics that identify individuals at risk before a crisis occurs.

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What Investors And Health Systems Are Getting Wrong

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Thangarajan鈥檚 critique of how addiction technology gets funded is the most direct. 鈥淎ddiction tech doesn鈥檛 create value only through app engagement or short-term symptom scores. Its real value is in avoided emergency visits, fewer readmissions, better medication continuity, lower justice-system contact, improved employment stability and families staying intact. Those outcomes are harder to capture in a 12-week pilot, but they are exactly where health systems lose money and lives.鈥�

He is arguing for a fundamental redesign: 鈥淔und addiction technology as recovery infrastructure, not consumer mental health software. The winning companies won鈥檛 be the ones with the slickest interface. They鈥檒l be the ones that prevent people from disappearing between crisis and recovery.鈥�

Astor reframes the debate through an investor鈥檚 lens. 鈥淚nvestors and healthcare commissioners must evaluate addiction technology based on lifetime cost avoidance rather than short-term reimbursement. Every prevented overdose, hospitalisation, incarceration, emergency room visit or child welfare intervention generates substantial savings across multiple systems. The question is not whether addiction technology works. It is whether we are willing to measure success over years instead of quarters.鈥�

That sentence perfectly captures the reality of the sector: the evidence for digital addiction support isn鈥檛 the problem 鈥� the timeline is. The technology exists, but the industry鈥檚 foundations haven鈥檛 caught up. The health systems and investment cycles haven鈥檛 caught up yet, and that鈥檚 what the category is still waiting on.