Craving and Anxiety Responses as Indicators of the Efficacy of Virtual Reality-Cue Exposure Therapy in Patients Diagnosed with Alcohol use Disorder

Introduction: Virtual Reality (VR) technology has shown promising results as an assessment and treatment instrument in substance use disorders, particularly in attempts to reduce craving. A common application of the VR technology in treatment is based on cue-exposure therapy (CET). Following from previous results, the present case series is part of a larger project aiming to test the efficacy of the Virtual Reality-Cue Exposure Therapy (VR-CET) versus Cognitive-Behavioral Therapy (CBT). Method: Eight patients between ages 40 and 55 (Mage = 49, SD = 5.54) from the Addictive Behaviors Unit at the Hospital Clinic of Barcelona participated in this study after providing written informed consent. Patients were randomly assigned to the VR-CET group (three patients) or the CBT group (five patients). The protocol of the clinical trial consisted of a pre-treatment session (the initial assessment session), six sessions of CBT or VR-CET, and a post-treatment session (post-assessment session). The VR-CET sessions consisted of exposure to alcohol-related cues and environments aiming to reduce anxiety and craving responses to alcohol-related stimuli. The CBT sessions consisted of classical standardized therapy for the treatment of addictions, as previously applied in other clinical trials. In the pre- and post-treatment sessions, patients completed several measures of alcohol craving and anxiety and visual analog scales (VAS) during VR exposure. Results: Our data indicated a significant reduction in both groups in all scores of craving and anxiety responses, as assessed by the different instruments. In addition, the VR-CET group obtained lower scores on anxiety and craving responses than the CBT group. Conclusions: In this ongoing project, the first phase of the clinical trial showed significant improvements in terms of craving and anxiety reduction in both groups, emphasizing that VR-CET can be as efficient as CBT. In addition, patients in the VR-CET group obtained slightly better scores than patients in the CBT group, suggesting the clinical potential of the VR technology in the treatment of substance use disorders. We propose that VR-based CET can be a useful complement to existing treatment methods for AUD patients.