Using Technology to Support Recovery: The New Role of Virtual Reality in Addiction Treatment

By Priscilla Sears - Linkedin 

Drug and alcohol addiction remains one of the most significant and challenging public health crises, both in the United States and across the entire world. In the United States alone, in 2022, almost 108,000 people died from drug-related deaths according to the CDC. Despite modern treatment plans, top-end rehab centers, and constant research, relapse and death rates remain staggeringly high. American Addiction Centers estimates that only 43% of people who start recovery treatment will finish the program. Among those who complete treatment, 40-60% will relapse at some point. With such high relapse rates, it is clear that addiction treatment requires more effective, science-backed approaches. According to an article published in the New England Journal of Medicine, addiction is not just a physical dependence. It involves behavioral patterns, emotional triggers, and cognitive processes, making psychological intervention essential for long-term recovery. 

Addiction treatment is a constantly evolving field and by integrating modern technology, addiction therapy could be revolutionized to offer a more effective, lasting solution. One of the latest innovations in addiction treatment is Virtual Reality Cue Exposure Therapy (VRCET). According to an article published in the Dialogues in Clinical Neuroscience, by immersing patients into a controlled, virtual environment that simulates real-world triggers, VRCET allows them to confront cravings and develop coping strategies in a safe space. The technology allows the clinician to intentionally provoke emotion, helping the patient resist triggers and deal with emotional responses. For psychology students, especially those exploring career pathways, understanding how modern technology can be used to treat patients is crucial. This treatment shows how the field of psychology and addiction treatment is always evolving and highlights how technology can be extremely beneficial for patients. As future psychologists and mental health professionals, understanding and working with advancements like VRCET will help students prepare to enter the workforce and make meaningful contributions to tackling some of society's toughest challenges.

According to TeamViewer, traditional virtual reality exposure therapy works by placing patients in realistic, simulated environments designed to recreate triggering stimuli. Originally developed in the 1960s to treat phobias such as public speaking and fear of heights, VR exposure therapy has since expanded to address PTSD, anxiety disorders such as agoraphobia, and more. By simulating environments such as a war zone, patients can process traumatic memories and practice emotional regulation. Modern VR systems have advanced significantly, now integrating AI to adapt the experience to individual users' responses, creating a more personalized and effective therapeutic environment. The science behind virtual reality has also progressed. VR headsets now use a combination of cameras, sensors, and LED infrared lights to track movement and create an immersive, lifelike experience. These technological improvements have made the therapy more realistic and adaptable, enhancing its effectiveness in clinical settings, and demonstrating promising potential in addiction treatment.

For addiction treatment utilizing cue exposure therapy, the program replicates real-world scenarios, such as a bar or party, that trigger cravings for substances like alcohol or drugs. This allows patients to practice coping skills in a safe, controlled space, helping to weaken conditioned responses and reduce cravings. The ability to tailor each environment to specific patients, their addictions, and their triggers makes VRCET a powerful and adaptable tool in addiction therapy. As this technology continues to evolve, its potential to transform addiction treatment by providing personalized, safe, and effective therapeutic environments is becoming increasingly clear.

Using virtual reality, cue-exposure therapy has many potential advantages over traditional addiction treatments, according to White Light Behavioral Health. Traditional therapy often relies on real-world experiences. The issue with this, however, is that they can be uncontrollable and unpredictable. The use of VRCET is safer for the patient as there is no risk of substance use, even if they are triggered during the treatment. This controlled exposure to triggers has been shown to reduce cravings while helping build emotional regulation. For individuals with mobility issues or those living in rural areas, VRCET offers a convenient alternative by providing treatment from home or at a nearby clinic. Traditional treatments often require relocation to a treatment center or include costly in-person sessions, whereas VRCET requires neither. By being conducted virtually, the cost can be much lower and is overall more accessible for patients to utilize. Most importantly, in addition to safety and accessibility, VRCET offers personalization in treatment. Psychology never has and never will be a one-size-fits-all field. Everybody is different, and they should be treated as such. Unfortunately, this tailoring of treatment is not always done. Especially in scenarios where there are a lot of people undergoing the same treatment at the same time, it can be hard to cater to individual needs. VRCET treatments can be individually tailored with AI, adapting to each patient's needs and evolving alongside their progress. Even a basic scenario can be programmed to individual cues or triggers. 

The past few years have seen the implementation of this treatment with promising results. A study published in BMC Psychiatry in 2023 researched the effect of using VR treatment for alcohol dependence. The study involved 44 alcohol-dependent males, divided into a control group of 21 patients and a study group of 23 patients. The control group received traditional alcohol dependency treatments, and the study group received both traditional treatments as well as virtual reality cue exposure therapy. The researchers measured the psychological cravings and physiological responses before and after treatment for all of the participants. The study group showed a significant decrease in self-reported cravings and heart rate after the treatment. However, there was no significant decrease in respiration or skin conduction before and after treatment. The control group found no significant decrease in any of the measured responses. These findings show that VR cue therapy can reduce cravings and some physiological responses and shows promise for the use of it to treat alcohol dependence disorder. A 2020 systematic review evaluating the effectiveness of VRCET in treating nicotine, alcohol, cannabis, gambling, and cocaine addiction found that VRCET led to measurable reductions in cravings and improved emotional regulation across multiple studies, showing promise for its broad application in addiction therapy. These studies highlight VRCET’s potential to revolutionize addiction treatment. While more research is needed, preliminary findings offer promising hope for more effective, technology-driven recovery solutions.

As technology continues to rapidly advance, virtual reality cue exposure therapy is set to become more and more effective. AI-driven VR treatment can create a personalized and adaptive experience for the patient. By analyzing responses in real-time, AI can adjust the treatment for a more precise and individualized experience. Advancements in gamification in the treatment is also a possible new way to improve experiences and outcomes. A study by Cheng and Ebrahimi in 2023 suggests that adding aspects such as rewards, points, and interactive challenges can become more appealing to users. In the context of VR cue therapy, gamification can improve engagement and motivation, making it easier for patients to achieve goals such as reducing cravings, managing triggers, and improving emotional regulation. While some studies show good results, others have found only small benefits. These differences might be due to the types of games used and how well they match the needs of different people. For gamified treatments to work well, they should be carefully planned, balancing personalization with standardization, and avoiding over-engagement that could interfere with the treatment goals. 

The success of VR cue therapy relies not only on the advancement of technology, but the skill and training of the clinicians to administer it. Clinicians need to be trained not only in traditional addiction treatment but also in how to effectively use this technology, interpret patient responses in real-time, and adjust treatment accordingly. This training is essential to ensure that the therapy is not only administered correctly but also tailored to meet individual patient needs, enhancing overall treatment efficacy. While traditional addiction treatment training remains crucial, few clinicians are equipped to deliver VR cue therapy. This highlights the need for updated curricula and professional development opportunities to ensure that practitioners are prepared for the future of addiction treatment. As it becomes more mainstream, educational and healthcare institutions will need to prioritize this training to ensure the maximum potential of this promising treatment. As these trainings are not mainstream, psychology students and those interested in addiction treatment should seek hands-on experience or education in this field. 

Virtual reality cue exposure therapy for addiction treatment is an emerging and potentially groundbreaking tool in psychology, offering a safe, customizable, and immersive experience that some traditional methods lack. By allowing patients to confront triggers in a controlled virtual environment, virtual reality enhances cue exposure therapy, helping to reduce cravings and prevent relapse. The growing body of research indicates the potential for this to transform addiction care, making treatment more accessible and engaging. As technology continues to advance, integrating artificial intelligence, gamification, and machine learning could further personalize VR therapy, allowing real-time adjustments based on patient behavior and enhancing engagement, which is key for sustained treatment success. Although early research is promising, further studies and clinical trials are crucial to fully understand VR cue therapy's long-term effectiveness, refine treatment protocols, and ensure its integration into standard addiction care practices. By embracing this innovative approach, virtual reality cue exposure therapy has the potential to transform addiction treatment, offering renewed hope for individuals seeking recovery and paving the way for the future of mental health care.

Actionable Steps

• Enroll in online or in-person courses to better understand both Virtual Reality, and digital healthcare, and how they overlap. Online resources such as Coursera partner with universities across the world to offer online courses. Helpful courses include Digital Health Specialization, offered through Imperial College London, Introduction to Virtual Reality and a Virtual Reality Specialization course offered through the University of London, and many more.
• Get hands-on experience at addiction recovery centers that utilize digital therapies, including virtual reality cue exposure therapy. Working or volunteering at these centers will help develop practical skills and an understanding of how technology is being used in clinical addiction therapy. This would allow observation and participation in real-world treatment outside of a classroom. Not only that but it will allow you to expand your network of professionals, a network that could benefit you in the future. 
• Join professional and online communities. Actively participating in groups focused on mental health, addiction treatment, virtual reality, the use of technology in treatment, and any combination of these will help expand your knowledge of the fields and the newest advancements. Networking within these groups can build valuable connections within the community for future employment opportunities and more.