Modular Adaptive Virtual Reality Intervention for Clinical Substance use disorder (MAVRICS)

项目总结/摘要 阿片类药物使用障碍（OUD）是一种慢性、复发性疾病，如果不加以治疗， 和持续的公共健康威胁。OUD与身体和精神方面的严重损害有关。 心理健康，包括死亡率增加和紧急医疗服务利用率高，以及 丙型肝炎和艾滋病毒感染以及新生儿禁欲综合征（NAS）的风险增加。OUD也是 与司法和儿童福利系统的参与增加有关。目前，根据经验， 用于治疗OUD的支持性行为干预是有限的，其中大多数无法定制 （定制）以满足个别客户的独特需求。因此，复发率为个人与 OUD仍然很高。 虚拟现实提示曝光（VRCE）在解决物质渴望方面表现出相当大的希望， OUD最重要的组成部分。通过在受控范围内反复接触药物使用线索 随着时间的推移，这些虚拟暴露会削弱物质使用线索之间的关系， 和渴望，可能导致减少物质使用和降低物质复发的可能性。 不幸的是，目前可用的商业VR产品缺乏简单和重复的基本能力， 更新暴露环境，以引入新奇或纳入新的或不断发展的物质使用线索。这 随着时间的推移，限制导致用户参与度降低，可能导致用户脱离和过早 治疗终止。 这项研究旨在改进目前可用的商业虚拟现实（VR）产品， 通过开发一种新的基于订阅的软件产品（Hacker）来解决药物滥用问题， 正在进行的基于虚拟现实的提示曝光（VRCE）环境的定制， 干预解决物质渴求。使用可衡量的基准进行标准化评估 可用性和可接受性，并根据关键利益相关者的焦点小组的反馈， 将不断改进，直到达到满意的可用性和可接受性水平。该软件将 还将进行评估，以确定它是否适用于住宅和门诊药物滥用 治疗设置。

PROJECT SUMMARY/ABSTRACT Opioid Use Disorder (OUD) is a chronic, recurring condition that if left untreated, poses a significant and ongoing public health threat. OUD is associated with significant impairments in physical and psychological health including increased mortality and high utilization of emergency medical care as well as increased risk of Hepatitis C and HIV infection and Neonatal Abstinence Syndrome (NAS). OUD is also associated with increased justice and child welfare systems involvement. Currently, the number of empirically supported behavioral interventions for the treatment of OUDs is limited, the majority of which cannot be tailored (customized) to meet the unique needs of the individual client. As such, the relapse rate for individuals with OUDs remains high. Virtual reality cue exposure (VRCE) has shown considerable promise in addressing substance craving, one of the most salient components of OUD. Through repeated exposure to substance use cues within a controlled virtual environment, over time these virtual exposures weaken the relationship between substance use cues and craving, potentially leading to decreased substance use and lower probability of substance relapse. Unfortunately, currently available commercial VR products lack the essential ability to easily and repeatedly update exposure environments to introduce novelty or incorporate new or evolving substance use cues. This limitation results in less user engagement over time, potentially leading to user disengagement and premature treatment termination. This research aims to improve upon currently available commercial virtual reality (VR) products designed to address substance misuse by developing a novel subscription-based software product (Helix) that supports ongoing customization of virtual reality-based cue exposure (VRCE) environments resulting in a tailored intervention addressing substance craving. Using measurable benchmarks on standardized assessments of usability and acceptability and informed by feedback from focus groups of key stakeholders, the Helix software will continually be refined until satisfactory levels of usability and acceptability are achieved. This software will also be evaluated to determine if it is feasible for use in both residential and outpatient substance abuse treatment settings.