by Renata Glavak-Tkalić, Mara Šimunović, Katarina Perić Pavišić, Josip Razum, Desirèe Colombo – – 22 August 2025

 

ABSTRACT

Background

Substance abuse (SA) imposes a significant global health burden, demanding innovative and accessible interventions. Virtual reality (VR) offers a promising approach, providing engaging and personalized treatment experiences. However, rigorous evidence from randomized controlled trials (RCTs) on VR’s efficacy in the treatment and prevention of SA remains limited. This systematic review aimed to characterize VR interventions for substance-related disorders and evaluate their effectiveness.

Methods

To conduct this review, two researchers independently performed a comprehensive literature search across four databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results

Twenty RCTs met the inclusion criteria, focusing on alcohol, nicotine and illicit drug use. These studies utilized diverse VR modalities, most frequently exposure therapy (n = 10) and cognitive-behavioural therapy (n = 5), followed by approach bias modification, skills training, cognitive rehabilitation, counterconditioning and psychoeducation. Interventions varied in level of immersion and interactivity. Although the evidence was mixed, 17 studies demonstrated positive effects on at least one outcome variable. Most studies focused on proximal outcomes (e.g., craving), which frequently showed improvement. Clinically meaningful outcomes (e.g., substance use reduction and abstinence) were less frequently assessed, with seven of 10 studies reporting improvement.

Conclusions

VR shows promise in addressing substance-related disorders, particularly for alcohol and nicotine. However, substantial heterogeneity in VR interventions highlights the need for further research to standardize methodologies, optimize treatment parameters and explore the underlying working mechanisms of VR interventions. Additional research is also needed to assess VR’s application to illicit drug use.

Summary

Virtual reality (VR)–based interventions, particularly those that integrate cue exposure therapy and cognitive behavioural therapy, show significant promise in reducing cravings and improving abstinence among individuals using alcohol and nicotine.

VR intervention and prevention programmes have positively impacted attitudes, intentions, cognitive function and physiological responses in substance users, indicating a broader therapeutic potential that extends beyond simply addressing addiction symptoms.

The considerable variability among VR interventions emphasizes the need for greater standardization in methodologies, treatment parameters and outcome measures.

Additional research is necessary to evaluate the applicability and efficacy of VR in the prevention and treatment of illicit drug use.

The full article can be accessed by clicking the ‘Source’ link below:

Source: https://onlinelibrary.wiley.com/doi/10.1002/cpp.70144?af=R