Integrating Episodic Future Thinking into Virtual Reality to Mitigate Substance Use Disorders: A Theoretical Framework

2019 ◽  
Vol 63 (1) ◽  
pp. 2282-2286
Author(s):  
Tianzi Wang ◽  
Alexandra M. Mellis ◽  
Nathan Lau ◽  
Warren Bickel
Keyword(s):  
Substance Use ◽  
Virtual Reality ◽  
Substance Use Disorders ◽  
Schema Theory ◽  
Theoretical Framework ◽  
Term Treatment ◽  
Episodic Future Thinking ◽  
Future Thinking ◽  
Individual Values ◽  
Long Term Treatment

Substance use disorders present major health risks and economic burdens, while current healthcare systems face insufficient resources and accessibility deficiencies that challenge long term treatment for chronic diseases. This paper presents a theoretical approach of integrating the concept of episodic future thinking into immersive virtual reality to treat substance use disorders. Episodic future thinking can extend the temporal window over which an individual values rewards, rebalancing the impulsive and executive decision systems and thereby reducing the valuation of substances of abuse. In theory, virtual reality can enhance episodic future thinking by providing realistic cues and contexts. We propose using schema theory to guide the design of virtual reality for facilitating episodic future thinking. Future work should focus on developing and evaluating a proof-of-concept of this theoretical framework.

Pharmacotherapy for substance use disorders within correctional facilities

2015 ◽  
Author(s):  
Sarah E. Wakeman ◽  
Josiah D. Rich
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Interventions ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Term Treatment ◽  
Opiate Dependence ◽  
Opioid Use ◽  
Long Term Treatment

Drug addiction treatment is increasingly complex. Only 5% of prisons and 34% of jails offer any detoxification services, and only 1% of jails offer methadone for opioid withdrawal. Even fewer facilities offer medication assisted therapy (MAT) for alcohol or substance use disorders despite the tremendous evidence base supporting the use of medications to treat addiction. Untreated opioid dependence both within corrections and in the community is associated with HIV, Hepatitis C, crime, and death by overdose. Substantial evidence argues that these risks are reduced through long-term treatment with agonist medications such as methadone and buprenorphine. Only a minority of prisoners receive any addiction treatment while incarcerated. Those that do are usually offered behavioral interventions, which when used alone have extremely poor outcomes. Although there are limited studies on the outcomes of drug treatment during incarceration, there are nearly 50 years of evidence documenting the efficacy of methadone given in the community in reducing opioid use, drug-related health complications, overdose, death, criminal activity, and recidivism. Buprenorphine is similarly an effective, safe, and cost-effective long-term treatment for opioid dependence that reduces other opioid use and improves health and quality of life outcomes. There is a growing role for MAT in jails, and to a lesser degree in prisons for the treatment of alcohol and opiate dependence. This chapter presents the current state of evidence based practice in correctional MAT models.

Bipolar disorder and substance use disorders in a Tunisian sample

2017 ◽  
Vol 41 (S1) ◽  
pp. S466-S466
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
R. Labbane
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Family Cohesion ◽  
Poor Quality ◽  
Term Treatment ◽  
Response To Treatment ◽  
Criminal Records ◽  
Long Term Treatment ◽  
Bipolar Patients

AimsDescribe the sociodemographic and clinical profile of patients suffering from bipolar disorder and substance use disorders comorbidity and assess the consequences of this comorbidity on prognosis and evolution of bipolar disorder,MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups of 50 patients were individualized by the presence or not of substance use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsCompared to bipolar patients without addictive comorbidity, those with this comorbidity had the following characteristics: we found more male, less family cohesion, more domestic violence, more criminal records, more time spent abroad, more personality disorders especially antisocial and borderline, fewer triggers of bipolar illness, more mood episodes, more psychotic features, higher impulsivity BIS-10 score, an increased need to put in a neuroleptic long term treatment, poor adherence to treatment, lower response to treatment, lower score of global assessment of functioning (GAF), more rapid cycles, shorter period of remission, longer duration of the last mood episode, poor socio-professional integration and poor quality of intervals between mood episodes.ConclusionsIt seems important to insist on the identification and the treatment of bipolar disorder or substance use disorders when one of them is diagnosed. This needs to set up urgently facilities and care structures for patients with substance use disorders and to create more addiction consultations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effects of episodic future thinking on reinforcement pathology during smoking cessation treatment among individuals with substance use disorders

2022 ◽  
Author(s):  
Ángel García-Pérez ◽  
Gema Aonso-Diego ◽  
Sara Weidberg ◽  
Roberto Secades-Villa
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Repeated Measures ◽  
Clinical Sample ◽  
Experimental Studies ◽  
Episodic Future Thinking ◽  
Future Thinking ◽  
Smoking Cessation Treatment ◽  
Cigarette Demand

Abstract Rationale Reinforcer pathology (RP) is a theoretical model based on two processes: delay discounting (DD) and drug demand. Given that RP has been shown to have a predictive value on smoking behaviors, several studies have explored which interventions can reduce RP. Consistent with the RP framework, episodic future thinking (EFT) has shown effects on treatment outcomes and RP processes. The vast majority of studies that assess the effects of EFT on RP consist of experimental studies, and no previous research has tested these effects in a clinical sample of smokers. Objectives The primary aim of this study was to assess the effects of EFT on RP throughout the course of a smoking cessation intervention in smokers with substance use disorders (SUDs). Methods Participants were randomized to cognitive behavior therapy (CBT) + EFT (n = 39) or CBT + EFT + contingency management (n = 33). Cotinine, frequency of EFT practices, cigarette purchase task (CPT), and DD were evaluated in treatment sessions. Mixed-effects model repeated measures analysis was used to explore DD and CPT in-treatment changes as a function of EFT practices and cotinine levels. Results Greater practice of the EFT component significantly reduced cigarette demand (p < .020) as well as DD (p = .003). Additionally, a greater reduction in cotinine levels coupled with greater EFT practice led to a greater decrease in cigarette demand (p < .014). Conclusions EFT reduced the two facets of RP in treatment-seeking smokers with SUDs.

Pharmacotherapy for substance use disorders within correctional facilities

2017 ◽  
Author(s):  
Sarah E. Wakeman ◽  
Josiah D. Rich
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Interventions ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Term Treatment ◽  
Opiate Dependence ◽  
Opioid Use ◽  
Long Term Treatment

Drug addiction treatment is increasingly complex. Only 5% of prisons and 34% of jails offer any detoxification services, and only 1% of jails offer methadone for opioid withdrawal. Even fewer facilities offer medication assisted therapy (MAT) for alcohol or substance use disorders despite the tremendous evidence base supporting the use of medications to treat addiction. Untreated opioid dependence both within corrections and in the community is associated with HIV, Hepatitis C, crime, and death by overdose. Substantial evidence argues that these risks are reduced through long-term treatment with agonist medications such as methadone and buprenorphine. Only a minority of prisoners receive any addiction treatment while incarcerated. Those that do are usually offered behavioral interventions, which when used alone have extremely poor outcomes. Although there are limited studies on the outcomes of drug treatment during incarceration, there are nearly 50 years of evidence documenting the efficacy of methadone given in the community in reducing opioid use, drug-related health complications, overdose, death, criminal activity, and recidivism. Buprenorphine is similarly an effective, safe, and cost-effective long-term treatment for opioid dependence that reduces other opioid use and improves health and quality of life outcomes. There is a growing role for MAT in jails, and to a lesser degree in prisons for the treatment of alcohol and opiate dependence. This chapter presents the current state of evidence based practice in correctional MAT models.

Achieving Remission and Favorable Outcomes in Patients with Depression/Anxiety and Substance use Disorders

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S6) ◽  
pp. 10-12 ◽  
Author(s):  
Alan F. Schatzberg
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Dependence ◽  
Psychiatric Symptoms ◽  
Term Treatment ◽  
Multiple Sources ◽  
Long Term Treatment ◽  
History Of ◽  
Relationship Of

Given the frequency with which patients with substance use disorders (SUDs) and those with psychiatric disorders, such as major depressive disorder (MDD) and generalized anxiety disorder (GAD), suffer relapses and recurrences, the issue of long-term treatment for SUDs warrants special attention. Faced with recommending long-term treatment, the clinician must discern the primacy of disorder, which may have been only obliquely addressed at the time of the patient's presentation and then solved by concurrent treatment. Establishing primacy relies on determining whether the psychiatric symptoms were induced by SUD or the psychiatric disorder emerged first and substance use was a means of coping with it. A third possibility exists—that the two disorders developed independently of each other, albeit becoming intermingled over time and serving to exacerbate each other. Clues to the temporal relationship of the disorders can be deduced from a meticulous history obtained from multiple sources, the effects that acute treatment has had on either condition, and the patient's willingness to remain abstinent from the addictive substance. Hasin and colleagues demonstrated the importance that a history of depression has on long-term remission and relapse outcomes in substance dependence (Slide 1).

scholarly journals Substance use, Unlike Dolutegravir, is Associated with Mood Symptoms in People Living with HIV

2021 ◽  
Author(s):  
Lisa Van de Wijer ◽  
Wouter van der Heijden ◽  
Mike van Verseveld ◽  
Mihai Netea ◽  
Quirijn de Mast ◽  
...  
Keyword(s):  
Substance Use ◽  
Term Treatment ◽  
Assessment Tools ◽  
Self Report ◽  
People Living With Hiv ◽  
Antiretroviral Drug ◽  
Long Term Treatment ◽  
Living With Hiv ◽  
Neuropsychiatric Side Effects

AbstractContradictory data have been reported concerning neuropsychiatric side effects of the first-line antiretroviral drug dolutegravir, which may be partly due to lack of control groups or psychiatric assessment tools. Using validated self-report questionnaires, we compared mood and anxiety (DASS-42), impulsivity (BIS-11), and substance use (MATE-Q) between dolutegravir-treated and dolutegravir-naive people living with HIV (PLHIV). We analyzed 194, mostly male, PLHIV on long-term treatment of whom 82/194 (42.3%) used dolutegravir for a median (IQR) of 280 (258) days. Overall, 51/194 (26.3%) participants reported DASS-42 scores above the normal cut-off, 27/194 (13.5%) were classified as highly impulsive, and 58/194 (29.9%) regularly used recreational drugs. Regular substance use was positively associated with depression (p = 0.012) and stress scores (p = 0.045). We observed no differences between dolutegravir-treated and dolutegravir-naive PLHIV. Our data show that depressed and anxious moods and impulsivity are common in PLHIV and associate with substance use and not with dolutegravir use.

Immersive Virtual Reality as a Non-Pharmacological Analgesic for Pain Management

2018 ◽  
pp. 1176-1199
Author(s):  
Diane Gromala ◽  
Xin Tong ◽  
Chris Shaw ◽  
Weina Jin
Keyword(s):  
Chronic Pain ◽  
Virtual Reality ◽  
Virtual Environments ◽  
Acute Pain ◽  
Term Treatment ◽  
Immersive Virtual Reality ◽  
Effective Form ◽  
Long Term Treatment ◽  
Difficult Challenge

In the 1990s, when immersive Virtual Reality (VR) was first popular, researchers found it to be an effective intervention in reducing acute pain. Since that time, VR technologies have been used for treating acute pain. Although the exact mechanism is unclear, VR is thought to be an especially effective form of pain distraction. While pain-related virtual environments have built upon pain distraction, a handful of researchers have focused on a more difficult challenge: VR for long-term chronic pain. Because the nature of chronic pain is complex, pharmacological analgesics are often insufficient or unsustainable as an ideal long-term treatment. In this chapter, the authors explore how VR can be used as a non-pharmacological adjuvant for chronic pain. Two paradigms for virtual environments built for addressing chronic pain have emerged – Pain Distraction and what we term Pain Self-modulation. We discuss VR's validation for mitigating pain in patients who have acute pain, for those with chronic pain, and for addressing “breakthrough” periods of higher pain in patients with chronic pain.

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