Effects of virtual reality-based interventions on craving in substance use disorders: A systematic review and meta-analysis of randomized controlled trials.

Abstract

To systematically evaluate the efficacy of virtual reality-based interventions in reducing craving among individuals with substance use disorders. Nine randomized controlled trials involving 553 participants (290 in the intervention groups and 263 in the control groups) were included, covering illicit drug, alcohol, and nicotine use disorders. Meta-analysis demonstrated that VR interventions significantly reduced craving in individuals with substance use disorders (SMD = -0.52, 95% CI [-0.78, -0.27], P < 0.05). This moderate effect size, considered alongside the distribution-based minimal clinically important difference threshold of approximately 0.5 standard deviations, suggests a potentially clinically meaningful improvement. Subgroup analyses indicated greater efficacy among individuals with illicit drug use disorders (SMD = -0.61). Interventions involving more than seven sessions (SMD = -0.60), session durations of less than 60min (SMD = -0.61), and VR cue exposure combined with neutral environments demonstrated comparatively superior effects. However, these subgroup findings should be interpreted cautiously due to the limited number of included studies. Current evidence indicates that virtual reality interventions may contribute to reducing craving among individuals with substance use disorder and demonstrate promising potential for clinical application. Although the included studies were generally of moderate-to-good methodological quality and the overall certainty of evidence was rated as moderate, the optimal intervention parameters have yet to be clearly established. Therefore, larger-scale and more rigorously designed randomized controlled trials are warranted to further confirm the clinical efficacy, stability, and generalizability of VR-based interventions.