# Virtual Reality Facilitation of Recovery from Opioid Use Disorder

> **NIH NIH R41** · RELATE XR, LLC · 2022 · $319,542

## Abstract

PROJECT SUMMARY / ABSTRACT
This Phase I project is a pilot randomized clinical trial designed to show commercial potential for a novel virtual
reality intervention in preparation for Phase II development. We propose testing our adjunctive intervention for
efficacy on reducing opioid use and increasing abstinence in early recovering opioid use disorder (OUD)
persons, with concomitant increases in self-reported and behavioral focus on future outcomes. Impaired future
orientation is a hallmark of OUD and other addictions. With recovery attempts usually failing within 6 months
of treatment, there is considerable room for improved efficacy. Converging evidence, including our preliminary
data, indicates that increasing visualization of the future should improve recovery outcomes. Our pilot testing
of the intervention was promising, with n=14 out of N=18 participants remaining abstinent 30 days later;
importantly, 10 of the 14 abstainers showed a positive response to the intervention, i.e., 100% of responders
remained abstinent—suggesting an efficacy marker. The VR intervention increased future self-identification
and delay-of-reward in people recovering from substance use disorder and engaged brain networks governing
prospection. Further, the VR effect on delay-of-reward correlated with introspective-executive brain
connectivity. Extending prior work on episodic future thinking, we employed a personalized, immersive virtual
experience that integrates personal details and maximizes sensory engagement. Our intervention increases
connectedness with one’s future through a realistic interaction with Future Selves in diverging futures resulting
from different choices. Importantly, we integrate self-discrepancy theory, focusing on the stark contrast
between these futures to heighten impact, and we promote engagement by maximizing the novelty and
emotional salience of the experience. Participants in early recovery enter a realistic virtual world, are
introduced to a time travel narrative, and interact with two digitally age-progressed Future Selves; one after 15
years of ongoing opioid abuse, and the other after 15 years of recovery. Future Selves speak to the participant
about their recovery rewards, or losses from returning to habitual drug use, and personal struggles during the
journey. Strong emphasis is placed on agency, optimism, and decision-making. After iterative development
and tests of feasibility and safety, the paradigm yielded a promising efficacy signal, behavioral change, and
brain target engagement. The current proposal will validate this paradigm in an expanded and more
homogenous OUD sample to show efficacy and behavioral mechanisms using the same VR paradigm. Aim 1
will test for efficacy on opioid use outcomes (days of use and abstinence) with longitudinal assessments at 30
days. Aim 2 will determine mechanisms by testing for changes in future self-identification, future orientation,
and behavioral delay discounting. Successful validation i...

## Key facts

- **NIH application ID:** 10390733
- **Project number:** 1R41DA055405-01
- **Recipient organization:** RELATE XR, LLC
- **Principal Investigator:** Andrew James Nelson
- **Activity code:** R41 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $319,542
- **Award type:** 1
- **Project period:** 2022-09-15 → 2025-09-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10390733

## Citation

> US National Institutes of Health, RePORTER application 10390733, Virtual Reality Facilitation of Recovery from Opioid Use Disorder (1R41DA055405-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10390733. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*