The use of virtual reality in craving assessment and cue-exposure therapy in substance use disorders
Open accessAbstract
Craving is recognized as an important diagnosis criterion for substance use disorders (SUDs) and a predictive factor of relapse. Various methods to study craving exist; however, suppressing craving to successfully promote abstinence remains an unmet clinical need in SUDs. One reason is that social and environmental contexts recalling drug and alcohol consumption in the everyday life of patients suffering from SUDs often initiate craving and provoke relapse. Current behavioral therapies for SUDs use the cue-exposure approach to suppress salience of social and environmental contexts that may induce craving. They facilitate learning and cognitive reinforcement of new behavior and entrain craving suppression in the presence of cues related to drug and alcohol consumption. Unfortunately, craving often overweighs behavioral training especially in real social and environmental contexts with peer pressure encouraging the use of substance, such as parties and bars. In this perspective, virtual reality (VR) is gaining interest in the development of cue-reactivity paradigms and practices new skills in treatment. VR enhances ecological validity of traditional craving-induction measurement. In this review, we discuss results from (1) studies using VR and alternative virtual agents in the induction of craving and (2) studies combining cue-exposure therapy with VR in the promotion of abstinence from drugs and alcohol use. They used virtual environments, displaying alcohol and drugs to SUD patients. Moreover, some environments included avatars. Hence, some studies have focused on the social interactions that are associated with drug-seeking behaviors and peer pressure. Findings indicate that VR can successfully increase craving. Studies combining cue-exposure therapy with virtual environment, however, reported mitigated success so far.
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VRET provides immersive three-dimensional environments and social interactions similar to the real world, and treats diseases in a novel and attractive way.
“VRET provides some immersive three-dimensional environments and social interactions similar to the real world, and it treats diseases in a novel and attractive way (17).”
From The efficacy of virtual reality exposure therapy for the treatment of alcohol use disorder among adult males: a randomized controlled trial comparing with acceptance and commitment therapy and treatment as usual (2023) · cites this paper as [17]
The Introduction describes VR as reconstructing environments and characters that allow social immersion and interaction; the Data Review discusses three-dimensional cues. But the paper concerns mainly substance use disorders, describes VR as a potential treatment tool, and reports mixed results for VR cue-exposure therapy. The General Discussion says VR may be more desirable in some clinical settings, not that it treats diseases generally in an attractive, established way. The indexed copy provides section labels but no page numbers. (LLM, conf=0.87)
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Giguère, S., Potvin, S., Beaudoin, M., Dellazizzo, L., Giguère, C., Fürtös, A., Gilbert, K., Phraxayavong, K., & Dumais, A. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13050766 · Cited by 10 · see citing works
Hastings, M. H., Gauthier, J. M., Mabry, K., Tran, A., Man, H., & Kantak, K. M. (2020) · Behavioural Brain Research · doi:10.1016/j.bbr.2020.112596 · Cited by 11 · see citing works
Liu, W., Andrade, G., Schulze, J. P., Doran, N., & Courtney, K. E. (2022) · JMIR Serious Games · doi:10.2196/32243 · Cited by 11 · see citing works
Fighting Alcohol Craving Using Virtual Reality: the Role of Social Interaction
Junker, A., Hutters, C., Reipur, D. B., Embøl, L., Adjorlu, A., Nordahl, R., Serafin, S., Petersen, D. T., & Fink‐Jensen, A. (2021) · IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW) · doi:10.1109/vrw52623.2021.00054 · Cited by 10 · see citing works
Walia, P., Ghosh, A., Singh, S., & Dutta, A. (2022) · Brain Sciences · doi:10.3390/brainsci12040445 · Cited by 10 · see citing works
Langener, S., Kolkmeier, J., VanDerNagel, J., Klaassen, R., van Manen, J. G., & Heylen, D. (2023) · JMIR Formative Research · doi:10.2196/42523 · Cited by 10 · see citing works
Thaysen‐Petersen, D., Hammerum, S. K., Vissing, A.-C., Arnfred, B. T., Nordahl, R., Adjorlu, A., Nordentoft, M., Oestrich, I. H., Düring, S. W., & Fink‐Jensen, A. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-068658 · Cited by 10 · see citing works
Oker, A. (2022) · Frontiers in Virtual Reality · doi:10.3389/frvir.2022.962129 · Cited by 9 · see citing works
Jimènez-Barragan, M., del Pino‐Gutiérrez, A., Valmaña, G. S., Monistrol, O., Marcet, C. M., Badia, M. P., Garrido, I., Ruiz, A. C., Roda, O. P., Esquinas, C., et al. (2025) · JMIR Human Factors · doi:10.2196/71708 · Cited by 9 · see citing works
Detrimental Effects of a Retrieval-Extinction Procedure on Nicotine Seeking, but Not Cocaine Seeking
Struik, R. F., Vries, T. J. D., & Peters, J. (2019) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2019.00243 · Cited by 9 · see citing works
Papini, S., Young, C. C., Gebhardt, C. S., Perrone, A., Morikawa, H., Otto, M. W., Roache, J. D., & Smits, J. A. J. (2020) · Contemporary Clinical Trials · doi:10.1016/j.cct.2020.106013 · Cited by 9 · see citing works
Winkler, M. H., Li, Y., Pauli, P., & Mühlberger, A. (2023) · Frontiers in Virtual Reality · doi:10.3389/frvir.2023.926679 · Cited by 8 · see citing works
Das Potenzial der virtuellen Realität in der Verhaltenstherapie
Diemer, J. (2019) · Nervenheilkunde · doi:10.1055/a-0928-0734 · Cited by 8 · see citing works
- Authors
- Hone-Blanchet, A., Wensing, T., & Fecteau, S.
- Affiliations
- Institut Universitaire en Santé Mentale de Québec (CA)
- Beth Israel Deaconess Medical Center (US)
- Venue
- Frontiers in Human Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2014-10-17
- Volume
- 8
- Pages
- 844-844
- ISSN
- 1662-5161 (ISSN-L)
- PMC
- PMC4201090
- OpenAlex
- W1995458275
- Cited by
- 188
- References
- 100
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 19 · 2023: 18 · 2022: 20 · 2021: 22 · 2020: 24 · 2019: 23 · 2018: 12 · 2017: 17 · 2016: 7 · 2015: 4
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Human Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Drug Abuse
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- virtual reality, craving assessment, cue exposure therapy, substance use disorders, relapse, abstinence, cue reactivity, virtual agents, avatars, peer pressure, drug-seeking behavior, alcohol consumption, ecological validity
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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