Tuesday, April 25, 2017
V is for Virtual Reality - Using Virtual Reality to Treat Alcohol Addiction
Virtual reality therapy has been shown to help alcoholics fight their addiction. VR treatment exposes patients to simulated situations that would normally trigger anxiety or cravings in a safe and controlled environment. One of the reasons advocates of the therapy say it is effective is that it allows treatment to be individualized for each person. The situations that each person is exposed to are specific to the environments that are most likely to lead to alcohol use.
In one study, following a week long detox, subjects were exposed to three virtual situations while practicing coping strategies to help them tolerate physiological and psychological cravings (Son, Lee, Seok, Kee, Lee, Kim, & Han, 2015). The first situation was a relaxing scenario. The second situation utilized a restaurant scenario involving other who were drinking alcohol. The third situation was an aversion scenario which included the sights, smells and sounds of others getting sick after drinking too much. Participants underwent two virtual reality sessions a week for five weeks. PET and CT scans evaluating changes in brain metabolism showed decreased cravings for alcohol following treatment completion compared to control subjects.
Although this study was only a preliminary investigation with a small number of subjects it does provide important implications. First, it suggests that those with alcohol dependence have an increased sensitivity to stimuli that trigger alcohol use which can be observed in their limbic system. This offers a potential method of evaluating pre and post treatment levels of cravings, which can help control for the low reliability of self-report measures.
The study results also suggest a potential treatment that uses exposure in life-like situations that can be administered and controlled in a therapeutic environment. Exposure has been repeatedly shown to be the most effective method of preventing relapse for alcohol use disorder. Avoiding high risk situations involving alcohol consumption may be recommended in the initial stages of therapy, but it is rare that this strategy can be maintained. Alcohol use is wide spread in our society and is often a part of socializing and celebrations. It is therefore, very difficult to continue to completely avoid situations and environments that include alcohol use. Since these situations often include the triggers that have led to a person imbibing in the past, unless they can work on maintaining sobriety in these high risk situations, relapse will be likely when exposed to these situations in the future.
However, it is also extremely risky to have the individual expose themselves to high risk situation in the absence of therapeutic support as would be done with other behavioral difficulties. Virtual reality allows those with alcohol dependence to practice coping techniques for resisting alcohol use in life-like scenarios. While cognitively the individual knows the situation isn’t real, the physiological findings suggest that this method may still successfully help to reprogram the brain when in real life situations. This could improve response to treatment as decreased physiological cravings could help the individual resist psychological cravings making cognitive behavioral techniques more effective with quicker results.
There are critics of the use of virtual reality treatment for alcohol and drug abuse. Some have stated that studying how the brain reacts during the scenarios would be crucial in understanding any neurological outcomes that may result. This can only be determined with MRI’s and other imaging techniques requiring the individual to be completely still, which is not possible when using virtual reality methods. Some researchers also question whether the use of VR treatment could make symptoms worse for some individuals due to the realistic nature of the treatment. Larger studies carried out using subjects of different ages, backgrounds and gender are needed to further investigate the effectiveness of virtual reality treatment for alcohol dependence and how individual characteristics effect treatment outcomes.
See this link for a video of how virtual reality is being used to treat a host of mental health difficulties and disorders.
della Cava, M. (2016, February 6). Virtual reality’s promise, risk loom large for health researchers. Retrieved from http://www.usatoday.com/story/tech/news/2016/02/02/virtual-reality-promise-and-concerns-both-loom-large-researchers/79360096/
Son, J. H., Lee, S. H., Seok, J. W., Kee, B. S., Lee, H. W., Kim, H. J., & Han, D. H. (2015). Virtual reality therapy for the treatment of alcohol dependence: a preliminary investigation with positron emission tomography/computerized tomography. Journal of studies on alcohol and drugs, 76(4), 620-627.