Stimulant Use Recovery Via Immersive Virtual Environments (SURVIVE)

Project Summary/Abstract The goal of the proposed research is to design and demonstrate the feasibility of a prototype system called Stimulant Use Recovery Via Immersive Virtual Environments (SURVIVE) for the treatment of stimulant use disorder (StUD). StUD, which includes the misuse of methamphetamine, cocaine, and other amphetamines, is associated with psychiatric and cardiovascular morbidity, infectious disease transmission, drug-associated crime, and housing insecurity1–5. Since 2013, increases in cocaine-involved overdose rates have been largely driven by opioid co-involvement6, and during 2020, 40% of fentanyl-related deaths also involved stimulants7. Given the increasing mortality, treating addiction to stimulants is critical. As of 2019, methamphetamine has surpassed opioids as the leading cause of overdose death in many western US states8. There are currently no Food and Drug Administration (FDA)–approved pharmacological treatments for StUD, and while cognitive behavioral therapy (CBT) is often used as an adjunctive treatment, relapse rates and treatment dropout remain high. To address these barriers to treatment, Charles River Analytics, along with our collaborator, Dr. Lisham Ashrafioun from the University of Rochester Medical School, propose to design and demonstrate the SURVIVE system. CBT content embedded into a virtual environment would provide a robust supplement to current CBT treatment practices, provide greater access to treatment, motivate adherence to the therapeutic program, and provide objective means of evaluating treatment effectiveness. Thus, under this award, we will leverage our team’s robust CBT, virtual reality design, addiction research, and human factors expertise to develop SURVIVE. SURVIVE will provide controlled environmental StUD triggers and CBT embedded into virtual environments and provide direct communication of patient-specific clinical evaluations. The long-term goal of this work is to utilize virtual reality (VR) as both an in-person tool and a telehealth solution to reduce the rate of relapse and treatment dropout in StUD patients by providing effective supplementary CBT treatment. Overall, SURVIVE has the potential to address barriers to treatment for StUD by providing a convenient and engaging means of delivering CBT treatment, and by providing clinicians with tools to personalize treatment, increase engagement, and validate the effectiveness of using a virtual environment for CBT treatment. The virtual environment will be overseen by a clinician to ensure the safety and effectiveness of treatment, while still allowing individuals to access treatment from the privacy of their own home or other location. By using VR technology, SURVIVE has the potential to improve access to CBT treatment, especially for individuals in rural or underserved areas where access to in-person treatment may be limited9–12. Additionally, the use of VR technology may reduce stigma and improve treatment outcomes by allowing individuals to practice coping strategies and skills in a realistic, safe, and controlled environment.