Harnessing VR to prevent substance use relapse

Substance use recovery is a life-long process, but environmental triggers, such as alcohol at social gatherings or pain medication advertisements, can put individuals in recovery at risk of relapse. Research by social work Professor Holly Matto, with colleagues from George Mason’s College of Science and School of Engineering, and their Brightline Interactive Industry partner, examined how positive stimuli, what they call "recovery cues," can counteract drug cravings and lower relapse risk. The team equipped individuals in recovery with virtual reality (VR) technology to see how relaxing sensory experiences can regulate their emotional and physical reactions to triggers to ultimately improve behavioral decision-making.  

Participants were offered customized recovery cues embedded in a variety of VR scenarios aimed at reducing their bodies’ reactions to drug triggers. Comfort and familiarity were key to recovery cues, Matto emphasized.  

“If we can identify an individual’s own set of personally meaningful recovery cues, we have the unique opportunity to present these cues to the individual as a real-time personalized intervention at the time of drug cue exposure and at the onset of craving escalation to help the person stabilize back to a regulated state,” she said. 

Recovery cues, such as visualizing a beloved pet or audio messaging with inspirational affirmations, reorient the individual onto the recovery path when faced with something that potentially ignites a drug craving. The most important cue for participants seemed to be the “12-step chip and pamphlet” when presented in the VR scenarios. The “12-steps” refer to the milestones that those overcoming addiction aspire to achieve in their recovery journey. This cue was highly effective, likely due to the recognizability it may elicit in the recovery community. 

Developing a “digital best self”  

Matto and colleagues are now working on two new research projects, building upon the findings of this study. The team is working on simulations that train individuals to implement their recovery cues so they can control their own reactions to drug cues. The goal is to help them develop a “digital best self” that represents the person they aspire to be in recovery. 

“Recovery is a process which requires learning opportunities that create change in the ways an individual engages their thoughts and feelings to motivate behavior in environments that present challenges to their recovery. VR offers an immersive space where that learning can occur and where relapse triggers can be presented in ways that require implementation of learned recovery strategies,” said Matto.  

Examining the Power of Recovery Cues to Enhance Real-Time Regulation and Manage Substance Craving was published in Families in Society: The Journal of Contemporary Social Services in June 2025.  

The George Mason research team includes Professor Padmanabhan Seshaiyer from the College of Science, Associate Professor Nathalia Peixoto from the School of Engineering, and Bioengineering PhD candidate Bryce Dunn.