The National Institutes of Health estimates nearly one in 10 Americans over the age of 12 has a substance abuse problem. University of Houston Professor Patrick Bordnick and team are addressing this serious matter.
Bordnick is helping recovering addicts discover ways to control alcoholism, drug abuse and other forms of addiction through an inventive tool called “The Cave.”
As a licensed clinical social worker, he challenges the modern way for therapists to help patients deal with addictions. The current common treatment is for therapists to role play with the patients to help them learn coping mechanisms in the comfort of a doctor’s office, but for Bordnick, this methodology seems marred with inherent flaws.
“I kept having a problem with the clinical setting. The patient knows there is a therapist in a clinical office. They know they are with a doctor. It’s incongruent with what they’re trying to learn,” he said. “So we thought, how can we put people into an environment that mimics the real world?”
The solution, The Cave, involves a virtual reality laboratory capable of replicating scenarios that potentially could trigger a relapse, all from the safety of a controlled environment. It is housed in the UH Graduate College of Social Work.
The lab employs a California-based team’s virtual reality designs, which are projected upon two walls in The Cave. The West Coast group synthesizes the virtual reality’s setting. Then, the UH research team helps them fine-tune the visualizations to even the subtlest of details, such as where to place a bottle of beer or what brand of cigarettes to incorporate into the scenery.
One of those team members is Luis Torres, associate dean for research and strategic partnerships. “We’re very involved from the beginning. We canvas and photo the community so that we can provide visual-spatial data,” said Torres. This data helps the developers to create the most authentic replication of what a drug addict is likely to encounter in day-to-day life.
Before any patients encounter the projections at The Cave, the designers and therapists take anywhere from 18 months to two years to build and finesse each scenario from start to finish. Once the visuals are created, the UH team tests the scenarios for accuracy and believability. “We test for the ecological validity of the scenario. It needs to look real,” said Torres.
Once completed and put into use, the projections work in conjunction with 3D glasses worn by the patient to enhance the images’ lifelike quality and a system that monitors the patient’s movements and reactions to the stimuli. The room also includes a machine that manufactures the scent of the surroundings — like a fresh pizza on a kitchen table — as well as audio features, including thumping music and people talking in the background to make the experience as realistic as possible.
The Cave allows Bordnick and his team to utilize a variety of situations and virtual reality designs to gain an intimate understanding of what triggers an addict’s cravings.
“We study what causes them to crave. Is it seeing people? Is it seeing the drugs? I can put an alcoholic in a party where everyone is drinking bottled water and no alcohol is present, and I can monitor if they have a similar craving when everyone is drinking alcohol,” said Bordnick. “We can separate all the facets of that environment to see what causes the craving.”
The Cave’s current scenarios can include alcohol, marijuana, cocaine, heroine and nicotine. An e-cigarette module is in development. Also, The Cave can help people deal with non-drug related stressors, including fear of flying, fear of heights and post-traumatic stress disorder.
Globally known in academia as the pioneer for virtual reality drug addiction recovery, Bordnick’s story is also a personal one. He dealt with food addiction before learning how to rethink his relationship with food in order to live a healthier life.
His experience in learning to shift his own cognitive behavior about food cravings provided a springboard into understanding the behaviors of other people who are affected by different desires and allows him to utilize The Cave for society’s benefit.
So far, the simulation has demonstrated a positive effect.
“Six months post study, people were adapting in ways that people without the virtual study hadn’t adapted to yet,” said Bordnick.
The next step is to develop a way to make this simulation portable. Bordnick says he is working with Google apps in attempt to port the environments into a smart phone so the patients can practice with the simulation outside of the lab.
Torres adds that he would like to extend the use of The Cave into the community. Given the low cost of producing the projections coupled with advances in technology, he remains optimistic about the future of virtual reality for recovering addicts.
“We want to partner with a few community agencies who provide recovery services and put this technology to use,” said Torres. “This could really make a dent in helping people with substance disorders.”