Progress in treatment on substance use disorders with virtual reality technologies

Abstract

Substance use disorder (SUD) is a chronic brain disease with a high rate of relapse that results from the complex interaction amongst physical, psychological, and social factors. To deal with this intractable brain disease, it is necessary to utilize a variety of treatment methods for comprehensive intervention under the guidance of integrative physical-social-psychological treatment model. Currently, the virtual reality (VR) technologies has been successfully used to investigate the effects of specific and context cue on the emotional, cognitive and behavioral response and craving in the persons with SUD, and new treatment methods on SUD with VR have been well developing. This technique synthesizes the immersive, interactive, and constructive technological advantages of VR to provide a complex changeable multi-factor interactive virtual environment. With the aid of VR technique, it is hoped that the quality and effects of cue-exposure therapy and behavioral therapy will make a new breakthrough. This article summarizes the research advances in this field within the last decade. It includes: To improve the validity of craving assessment by providing the drug-related cues and contexts more similar with the real life environments, combined with multiple levels of craving assessment methods like subjective report, eye movement tracking, heart rate, galvanic skin response and electroencephalograph; To improve the ecological validity of cue exposure therapy by extinguishing the cue response with multiple drug-related cues and contexts, and the trans-context extinction training will reduce the spontaneous recovery, which is the big challenge in regular cue exposure therapy; To improve the coping skill on how to deal with high relapse risk environments by training the coping skills in the virtual environments with social pressure context associated with drug-related cues; To improve the therapeutic effect of regular psychological and behavioral therapy, like cognitive behavioral therapy. In sum, the virtual reality procedures have some advantages in the subjective and objective assessment of craving, and improvement of therapeutic effect by providing a flexible and controllable platform to integrate different psychological and behavioral therapies under the virtual environments with specific complex drug-related cues, contexts and social interaction. The specificity created by virtual reality techniques holds the great promise to the development of individualized care and treatment in SUD. The future researches will focus on how to increase the sense of presence and reduce the sensations of nausea, and then to elevate the individual involvement to the virtual environments.