The Effect of Aversive Therapy Using Virtual Reality on Craving, Depression, and Self‐Efficacy: A Pilot Study in Patients Under Methadone Maintenance Treatment

Objective: This study aims to evaluate the effectiveness of virtual reality-based aversion therapy in reducing craving, alleviating depression, and improving self-efficacy in patients with substance use disorders undergoing methadone maintenance therapy. Methods: The research was conducted as an interventional clinical trial involving 90 participants aged 25 to 55 years from outpatient treatment centers. The participants were randomly assigned to one of three groups: a group that received virtual reality-based aversion therapy combined with methadone, a group that received psychological counseling combined with methadone, and a group that received methadone only. Results: The findings revealed significant differences between the groups' means for depression (F = 19.652, p = 0.000), self-efficacy (F = 33.956, p = 0.000), and craving (F = 65.445, p = 0.000 for desire and intent to use substances; F = 45.931, p = 0.000 for craving and negative reinforcement; F = 76.202, p = 0.000 for pleasure and intensity of lack of control). Specifically, virtual reality-based aversion therapy significantly reduced the desire and intent to use substances, craving and negative reinforcement, and pleasure and intensity of lack of control compared to both psychological counseling and control groups. It also significantly reduced depression and enhanced self-efficacy compared to both psychological counseling and control groups. This therapy, implemented through Python programming in a virtual reality environment with interactive and controlled simulations, facilitated gradual exposure to negative stimuli, cognitive restructuring, and the reinforcement of positive behaviors. Conclusion: The results underscore the high potential of virtual reality–based aversion therapy to improve the effectiveness and quality of substance abuse treatment. This study emphasizes the necessity of further research in this field to improve therapeutic interventions and presents virtual reality-based aversion therapy as an innovative, complementary, or alternative approach to substance use treatment.