Advances in Treatment: Virtual Reality Cue Exposure for the Treatment of SUDs

Substance use disorders (SUDs) are chronic, recurring conditions that if left untreated, pose a significant and ongoing public health and safety threat. ^1-5 Craving, a strong repeated urge or desire to use substances, is one of the most salient components of SUDs.^6-10 Virtual reality cue exposure (VRCE) has shown promise in addressing substance craving.^11-16 This oral presentation will present data from a group of substance use treatment professionals and individuals in sustained recovery who tested and evaluated a new VR based digital therapeutic for the treatment for SUDs.

High levels of craving are associated with continued substance use and put individuals in recovery at risk of relapse. Craving is most frequently evoked by exposure to environmental stimuli, termed “substance use cues” which are associated with one’s prior substance use. VRCE places individuals with a history of substance use in controlled virtual environments mirroring their “in vivo” use environments, safely exposing them to their most salient substance use cue, allowing them to practice skills such as substance refusal and management of craving. As users in the virtual environments experience craving without the ability to engage in actual substance use, these exposures weaken the relationship between substance use cues and actual substance use.^15-17

The newly created Helix^VR digital therapeutic has significant potential for improving patient care and reducing health disparities. The prototype of Helix^VR was tested with a group of substance use treatment providers (n = 12) and a group of individuals in recovery (n = 11) to evaluate the acceptability, feasibility, and usability of the product. User testing was followed up by virtual focus groups asking additional questions about participants’ experiences using Helix^VR including ease of use, what they did and did not like, applicability to their client population, and how feasible it would be to implement Helix ^VR as a part of residential and outpatient treatment.

Data were collected on participants’ experiences of presence and immersion, usability, substance craving, simulator sickness and their overall comfort with using technology.^18-19 Independent t-tests were conducted to investigate the difference in scales/subscales between different user types (peer vs. therapist), gender (female vs. male), and race (White vs. black, indigenous, and other people of color - BIPOC). Individuals in recovery rated Helix^VR higher in interface quality, a subscale of Presence Questionnaire, and rated it higher in cognitive Involvement. BIPOC participants scored higher in adaptation, a subscale of Presence Questionnaire, meaning they felt more like they were a part of the virtual environment than non-BIPOC participants. The evaluation of system usability was conducted using the System Usability Scale¹¹⁸ and the levels of usability for the Helix^VR digital therapeutic scored in the 88 percentile, indicating above average performance. Qualitative data from the development and product testing established the feasibility and acceptability of this VR based tool as well as ease of integration into usual substance use treatment workflows through the implementation of therapist-and self-administered mobile/web-based platform. Implications for substance use treatment and education will be offered.