Virtual Reality for Substance Use Disorders

(RENTS Trial)

Recruiting in Palo Alto (17 mi)

Overseen by Brandon G Oberlin, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Indiana University

Must be taking: Psychotropic drugs

Must not be taking: Mu-opioid drugs

Disqualifiers: Unstable medical, psychiatric, others

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial uses virtual reality technology to help people in early recovery from stimulant addiction. The VR sessions aim to reduce drug use by promoting positive future thinking and encouraging delayed gratification.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, it mentions that participants can be on psychotropic drugs for substance use disorder comorbidity, so you may be able to continue those medications.

What data supports the effectiveness of the treatment Virtual Reality Therapy for Substance Use Disorders?

Research shows that Virtual Reality Therapy can help reduce cravings and improve emotional regulation in people with substance use disorders. It has also been effective in treating anxiety and phobias, suggesting it could be beneficial for substance use disorders by providing realistic and personalized exposure to triggers.

^{1 2 3 4 5}

Is Virtual Reality Therapy safe for treating Substance Use Disorders?

Virtual Reality Therapy is generally considered safe for treating Substance Use Disorders, as long as risks like relapse and trauma are managed. It has been used safely in other conditions like anxiety and phobias, and practitioners believe it can be safely integrated into treatments for adults with mental health issues.

^{1 2 3 4 6}

How is Virtual Reality Therapy different from other treatments for substance use disorders?

Virtual Reality Therapy is unique because it uses immersive, computer-generated environments to help patients manage cravings and practice life skills in realistic scenarios. Unlike traditional therapies, it allows for personalized exposure to triggers and the use of avatars to simulate interactions, offering insights that other treatments cannot provide.

^{1 2 3 4 6}

Eligibility Criteria

This trial is for adults over 18 who have been abstinent from stimulants for at least 14 days but no more than 6 months, are committed to recovery, and can understand English. They must be outpatients possibly taking psychotropic drugs for substance use disorder-related issues and sober from drugs/alcohol for at least 24 hours before study visits.

Inclusion Criteria

I am not currently hospitalized.

Drug/alcohol abstinence ≥ 24 hours at the time of the study day visit

I am committed to following my treatment and recovery plan.

Exclusion Criteria

I am under 18 years old.

Unstable medical disorders

Habitual drug use

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a Virtual Reality intervention aimed at reducing stimulant use and increasing abstinence

Study Day Visit

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at 30-day and 6-month intervals

6 months

2 visits (in-person)

Participant Groups

Researchers are testing a virtual reality intervention to see if it helps people with stimulant use disorders by reducing their drug use days, increasing abstinence periods, boosting future self-identification, enhancing the ability to wait for rewards, and improving perspective on the future.

Group I: Virtual Reality Experimental Treatment 1 Intervention

Participants in this arm will receive the following interventions: Virtual Reality Park Virtual Reality Avatar

Group II: Treatment As Usual Placebo Group 1 Intervention

Participants in this arm will receive the following interventions: Virtual Reality Park

Virtual Reality is already approved in United States for the following indications:

🇺🇸 Approved in United States as Virtual Reality Therapy for:

• Functional Dyspepsia
• Irritable Bowel Syndrome (IBS)
• Gastroparesis

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

Indiana University School of Medicine - Goodman Hall Indianapolis, IN

Who Is Running the Clinical Trial?

Indiana University Lead Sponsor

National Institute on Drug Abuse (NIDA) Collaborator

References

1. England pubmed.ncbi.nlm.nih.gov

A systematic review of virtual reality therapies for substance use disorders: Impact on secondary treatment outcomes. [2023] Virtual reality (VR) therapy may be an effective tool in treating urges and cravings in substance use disorder (SUD). Given the high co-occurrence of difficulties with mood, anxiety, and emotional dysregulation with SUD, this review sought to examine the extant literature on the efficacy of VR for SUD in improving these secondary treatment outcomes.

2. Switzerland pubmed.ncbi.nlm.nih.gov

Avatar Intervention for Cannabis Use Disorder in Individuals with Severe Mental Disorders: A Pilot Study. [2023] Cannabis use disorder (CUD) is a complex issue, even more so when it is comorbid with a severe mental disorder (SMD). Available interventions are at best slightly effective, and their effects are not maintained over time. Therefore, the integration of virtual reality (VR) may increase efficacy; however, it has not yet been investigated in the treatment of CUD. A novel approach, avatar intervention for CUD, uses existing therapeutic techniques from other recommended therapies (e.g., cognitive behavioral methods, motivational interviewing) and allows participants to practice them in real-time. During immersive sessions, participants are invited to interact with an avatar representing a significant person related to their drug use. This pilot clinical trial aimed to evaluate the short-term efficacity of avatar intervention for CUD on 19 participants with a dual diagnosis of SMD and CUD. Results showed a significant moderate reduction in the quantity of cannabis use (Cohen's d = 0.611, p = 0.004), which was confirmed via urinary quantification of cannabis use. Overall, this unique intervention shows promising results. Longer-term results, as well as comparison with classical interventions in a larger sample, are warranted through a future single-blind randomized controlled trial.

3. Switzerland pubmed.ncbi.nlm.nih.gov

Views of Practitioners and Researchers on the Use of Virtual Reality in Treatments for Substance Use Disorders. [2021] Virtual Reality Therapy (VRT) has been shown to be effective in treating anxiety disorders and phobias, but has not yet been widely tested for Substance Use Disorders (SUDs) and it is not known whether health care practitioners working with SUDs would use VRT if it were available. We report the results of an interview study exploring practitioners' and researchers' views on the utility of VRT for SUD treatment. Practitioners and researchers with at least two years' experience delivering or researching and designing SUD treatments were recruited (n = 14). Interviews were thematically analyzed, resulting in themes relating to the safety and realism of VRT, and the opportunity for the additional insight it could offer to during SUD treatment. Participants were positive about employing VRT as an additional treatment for SUD. VRT was thought suitable for treating adults and people with mental health issues or trauma, provided that risks were appropriately managed. Subsequent relapse, trauma and over-confidence in the success of treatment were identified as risks. The opportunity VRT offered to include other actors in therapy (via avatar use), and observe reactions, were benefits that could not currently be achieved with other forms of therapy. Overall, VRT was thought to offer the potential for safe, realistic, personalized and insightful exposure to diverse triggering scenarios, and to be acceptable for integration into a wide range of SUD treatments.

4. Switzerland pubmed.ncbi.nlm.nih.gov

Virtual Reality (VR) in Assessment and Treatment of Addictive Disorders: A Systematic Review. [2020] Background: Substance Use Disorder (SUD) and behavioral addictions are common and require a multidisciplinary approach. New technologies like Virtual Reality could have the potential to improve assessment and treatment of these disorders. Objective: In the present paper, we therefore present an overview of Virtual Reality (Head Mounted Devices) in the field of addiction medicine for craving assessment and treatment. Method: We conducted a systematic review by querying PubMed database for the titles of articles published up to March 2019 with the terms [virtual] AND [addictive] OR [addiction] OR [substance] OR [alcohol] OR [cocaine] OR [cannabis] OR [opioid] OR [tobacco] OR [nicotine] OR [methamphetamine] OR [gaming] OR [gambling]. Results: We screened 319 abstracts and analyzed 37 articles, dividing them into two categories, the first for assessment of cue reactivity (craving, psychophysiological response and attention to cue) and the second for intervention, each drug (nicotine, cocaine, alcohol, cannabis, gambling) being detailed within each category. Conclusions: This overview suggest that VR provide benefits in the assessment and treatment of substance use disorders and behavior addictions and achieve high levels of ecological validity. While, craving provocation in VR is effective across addiction disorders, treatments based exclusively on virtual exposure to drug related cues as shown heterogenous results.

5. Switzerland pubmed.ncbi.nlm.nih.gov

Virtual reality intervention effects on future self-continuity and delayed reward preference in substance use disorder recovery: pilot study results. [2023] Sustained remission from substance use disorder (SUD) is challenged by high relapse rates, which provides opportunities for novel clinical interventions. Immersive virtual reality (VR) permits delivering synthetic experiences that feel real and actualizes otherwise impossible scenarios for therapeutic benefit. We report on the feasibility of an immersive VR intervention designed to increase valuation of the future by enhancing future self-continuity and leveraging future self-discrepancy with personalized future selves as SUD recovery support. Twenty-one adults in early SUD recovery (< 1 year) interacted with versions of themselves age-progressed fifteen years from two different behavioral trajectories: an SUD Future Self and a Recovery Future Self. The future selves' interactive monologs include personalized details and voice for a lifelike interaction within a time travel vignette. Before and following the intervention, participants rated future self-continuity and performed delay discounting. Following the intervention, daily images of the Recovery Future Self were sent to participants' smartphones for thirty days. The VR intervention generated no adverse events, was well tolerated (presence, liking, and comfort), and significantly increased future self-continuity and delayed reward preference (doubling delay tolerance). The intervention also reduced craving, ps < 0.05. Thirty days later, n = 18 remained abstinent; importantly, increased future self-similarity persisted. Abstainers' future self-similarity increased following VR. All individual participants showing increased future self-similarity post-VR remained abstinent, and all participants who relapsed showed either reduced or zero effect on future self-similarity. Post-intervention semi-structured interviews revealed emotional engagement with the experience. VR simulation of imagined realities reifies novel clinical interventions that are practicable and personalized. The current study demonstrates an implementation readily applied in the clinic and shows promise for facilitating SUD recovery. Creative collaboration between researchers, clinicians, and VR developers has great potential to revolutionize mental health interventions and expand the range of tools for clinicians targeting SUD and other disorders.

6. United States pubmed.ncbi.nlm.nih.gov

Virtual Reality for Individuals With Substance Use Disorders. [2019] Substance use disorders (SUDs) remain difficult to treat, with relapse rates averaging 50% despite available treatment. There is a need for new and novel treatment for treating SUDs. The use of virtual reality (VR) shows promising results as a strategy to help patients with SUDs manage cravings, say no to substance use, reduce stress and anxiety, treat pain, learn life skills, exercise, and use as a substitute for substance use. In VR, patients use a head-mounted device to experience computer-generated 360° simulated environments. Studies have shown that VR activates some of the same areas of the brain that substances activate. The science and technology of VR is evolving, resulting in more affordability, but the price is likely still a barrier for most treatment providers and patients. In addition, applications used to treat SUDs were developed for use in research and are not currently available for public use. More rigorous studies are needed to determine the effectiveness of VR as a treatment for SUDs. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 15-19.].