Towards virtual reality exposure therapy for cocaine use disorder: A feasibility study of inducing cocaine craving through virtual reality

Lehoux, Thomas; Porche, Christelle Nithart; Capobianco, Antonio; Gervilla, Miguel; Lecuyer, Flavien; Anthouard, Julien; Weiner, Luisa

doi:10.1016/j.abrep.2024.100549

Cited by 1 publication

(2 citation statements)

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“…In addition, in order to increase participants embodiment in VR, i.e., the sense of ownership and agency over the virtual body [ 50 ], participant virtual skin color will be personalized on request. Finally, for safety and acceptability purposes, given long lasting carry-over effects that could be expected on substance craving and emotional states post cue-exposure [ 51 ], VRCEs will have a 10-min washout period, and VRCET sessions will systematically end with a cool-down relaxing procedure with craving check [ 29 , 52 ].…”

Section: Methods: Participants Interventions and Outcomesmentioning

confidence: 99%

“…Interestingly, in one study, ecological validity in VRE was found to moderate and enhance craving induction in heavy drinkers [ 26 ]. Finally, numerous studies have demonstrated that VRE to substance cues might be feasible and capable to induce craving response in nicotine, alcohol, but also in cocaine users (for a systematic review: [ 27 – 29 ]). Consequently, VRE to substance cues might be of relevant interest in addictology settings for diagnostic, prognostic and treatment purposes (for a systematic review, see: [ 30 ]).…”

Section: Introductionmentioning

confidence: 99%

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Virtual reality cue-exposure therapy in reducing cocaine craving: the Promoting Innovative COgnitive behavioral therapy for Cocaine use disorder (PICOC) study protocol for a randomized controlled trial

Lehoux,

Capobianco,

Lacoste

et al. 2024

Trials

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Background Cocaine craving is a central symptom of cocaine use disorders (CUD). Virtual reality cue-exposure therapy for craving (VRCET) allows more immersive, realistic, and controllable exposure than traditional non-VR cue-exposure therapy (CET), whose efficacy is limited in treating substance use disorders. The purpose of this study is to evaluate the efficacy and acceptability of VRCET, as a stand-alone and add-on intervention (i.e., combined with cognitive therapy), compared to a picture-based CET (PCET), in reducing self-reported cocaine craving in inpatients hospitalized for CUD. Methods Fifty-four inpatients hospitalized for CUD will be randomized in one of two intensive 3-week treatment arms: 10 meetings/2-week treatment of VRCET plus 5 meetings/1-week treatment of memory-focused cognitive therapy (MFCT; experimental arm), or 15 meetings/3-week treatment of PCET (active control arm). The Craving Experience Questionnaire (CEQ – F & S) will be used to assess the primary outcome, i.e., the post-treatment decrease of self-reported cocaine craving frequency (within the past 2 weeks) and intensity scores (in VR exposure to cocaine cues). Secondary endpoints include urinary, physiological, and self-reported cocaine use-related measures. Assessments are scheduled at pretreatment, after 2 weeks of treatment (i.e., VRCET vs. PCET), post-treatment (3 weeks, i.e., VRCET + MFCT vs. PCET), and at 1-month follow-up. Acceptability will be evaluated via (i) the Spatial Presence for Immersive Environments – Cybersickness along VRCET and (ii) the Client Satisfaction Questionnaires after 2 weeks of treatment and post-treatment. Discussion This study will be the first to evaluate the acceptability and efficacy of VRCET for CUD, as a psychotherapeutic add-on, to reduce both cocaine craving frequency and intensity. Additionally, this study will provide evidence about the specific interest of VRCET, compared to a non-VR-based CET, as a cue reactivity and exposure paradigm for treating substance use disorders. Trial registration NCT05833529 [clinicaltrials.gov]. Prospectively registered on April 17, 2023.

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