Virtual Alcohol Control

So Bordnick is taking a different approach, creating virtual reality scenarios to mentally prepare alcoholics for situations that could trigger drinking.

The scenarios include scenes of a party, such as a comfortable atmosphere complete with a chatting crowd unwinding with a beer.

Bordnick hopes that this new avenue of research could make addiction therapy a lot more effective. "If we can have a virtual scenario, where we put that person in that bar, or in that social setting, and now have the therapist be able to teach you in real time… I think that will hold up when they are out in these realistic situations in the real world, that these skills should transfer from virtual reality to the real world," Says Bordnick.

Bordnick developed these virtual reality scenarios with the help of technology company Virtually Better. He's been using their hardware and software to study addiction in cigarette smokers, cannabis smokers, and now in alcoholics. In his most recent study, published in the journal "Addictive Behaviors," Bordnick found that alcohol dependent participants reported a greater urge to drink while viewing triggers like a bartender or a favorite cocktail, compared to viewing a neutral scene, such as a room filled with videos of nature scenes.

image: Patrick Bordnick and Virtually Better

During the course of the experiment, the 40 alcohol dependent participants were asked to put on a virtual reality headset and move through a number of the different tempting environments. These included a party in a small apartment and a kitchen filled with various forms of alcohol, among others. Participants were asked to move around the different rooms, and then rate their need to drink.

But what made this particular study so innovative, compared to the studies he had run previously, was Bordnick's decision to include not only the ability to see and hear these environments, but also the ability to smell them.

"This is the first trial to use scent," says Bordnick, "so we have computer controlled scents, so when you walk by a shot of tequila on the bar, or a beer, you automatically smell beer."

This smelly addition to the study was not just limited to triggers like the smell of beer or tequila. Bordnick even programmed in smells that would connect to the specific scenarios. but not necessarily to alcohol. As he describes, "When you walk out of this party, onto this sort of patio area, you smell outdoors, sort of pine scent or flowers. So it encompasses both specifics scents, as well as environmental."

Bordnick says that this kind of realism is critical to the next step — seeing whether the scenarios can help addicts to learn coping skills. "We've demonstrated that virtual reality triggers for smoking, for cannabis, and now in this particular study, for alcohol, are real enough to get real world reactions." Bordnick says coping with those reactions virtually, could make the 'real world' a lot less tempting.

He is now working on studies that focus on developing future therapy techniques, where a patient could be guided through a virtual scenario, and taught what sort of behaviors and personal interactions to avoid. As Bordnick puts it, "The therapist is allowed to, in their particular clinic setting, put the person into a real world social situation, and teach them in real time, skills not to use."

He expects that such skills would carry over in the patients' day-to-day lives, and hopefully help them avoid using and abusing alcohol and drugs in the future.

This study was published in the June 2008 issue of Addictive Behaviors and was funded by the National Institutes of Health, the National Institute on Drug Abuse, and the National Institute on Alcohol and Alcoholism.