Technology and Addiction Recovery
Can digital devices help you stay sober?
Posted Mar 18, 2016
I write quite a lot about the interaction of technology and addiction. Typically, I’m focused on the ways in which technology serves as a driver for addiction. For instance, digital technologies are used to facilitate alcoholism and drug addiction, with cases of wine ordered on eBay and Amazon and shipped directly to an alcoholic’s home, prescription meds (especially opiates) ordered online and shipped illegally from other countries, illicit drug dealers setting up “buys” via text message and video chat, etc. Tech also enables gambling addictions, shopping addictions, compulsive porn use, and all sorts of other behavioral addictions and compulsions.
Of course, there are two sides to every coin, and the flip side of this one is that technology can be used to facilitate recovery from addictions just as easily and effectively as it can be used to drive them. And new ways to do this are cropping up almost daily. In fact, since the beginning of this year I’ve discovered three excellent new tools:
- InTheRooms.com, an online recovery community offering information and social support for pretty much any addiction
- Brainbuddy, an app specifically designed to help compulsive porn users
- Virtual reality headsets used to role play potentially slippery situations
Online meetings are not exactly a new phenomenon, nor are online support communities. In fact, I’ve been steering my clients toward both of these options for many years. InTheRooms, however, seems to have brought these things together in an extremely effective way. With over 400,000 members, ITR is by far the world’s largest online network for recovering people. As of today, there are active discussion forums for 29 separate 12-step fellowships, with video meetings at least once per week for most of these groups. Alcoholics Anonymous, Narcotics Anonymous, and Al-Anon actually have multiple video meetings every day. There is also a weekly newsletter, plus a separate website for expert blogging.
Recovery apps are also nothing new. In fact, there are literally hundreds of apps designed to facilitate sobriety. Brainbuddy is a relative latecomer to the party, but without doubt one of the better apps available. (I was at a conference a few weeks back where I talked to several guys who were using the app, and they all raved about it.)
There are two things that I particularly like about Brainbuddy. The first is that it focuses on an otherwise underserved population – those who struggle with compulsive porn use and/or compulsive masturbation. The second is that it incorporates proven treatment techniques in a unique and useful way – in particular the cognitive behavioral approach, where addicts are taught to recognize their triggers toward addictive or compulsive behaviors, to “experience” what they are feeling, and to respond in a non-addictive, non-compulsive way (by doing something that is healthy and enjoyable and unrelated to porn). In short, Brainbuddy asks users to perform a guided check in each day, allowing the app to monitor a user’s mood and habits, eventually deciphering what the user’s triggers for porn usage are and then assigning, based on this information, a “daily mission” (an alternative task) that the user can turn to instead of porn if/when he or she feels tempted.
Virtual Reality Headsets
By far the most exciting new “tech and recovery” development, as far as I’m concerned, is the use of virtual reality (VR) headsets, as pioneered by Dr. Patrick Bordnick at the University of Houston. Essentially, VR is used to facilitate and enhance a tried and true addiction treatment strategy – cognitive reprogramming via directed role play.
With traditional role play, an addiction treatment specialist asks the client to visualize a situation in which he or she might be tempted toward relapse. For instance, I might ask a 25-year-old male alcoholic to envision himself at a party full of other twenty-somethings, where alcohol is plentiful and pretty much everyone is drinking. Then, pretending to be another young person at the party, I would offer him a beer, which he would then (hopefully) decline. The idea is to walk the addict through a potential relapse situation, helping him to build and practice the skillset he needs to stay sober.
The problem with traditional role play is that the context is all wrong. It’s very difficult for the 25-year-old client described above to become immersed in the role playing scenario when he’s sitting on a couch in his therapist’s office talking to a guy who’s older than his father. It’s like holding basketball practice in your living room with ballerinas filling in as your teammates. Yes, it’s better than nothing, but it’s not very good.
Recognizing this, Dr. Bordnick has created 3D virtual environments (parties, drug houses, and the like) into which he can insert addicts through use of VR headsets – enhancing the visual immersion with realistic sounds, odors, and whatever else he can manage. Using VR in this way, Dr. Bordnick is able to bring the real world, with its very real temptations, into the therapy space. For instance, he’s got the world’s only heroin injecting avatar, so when addicts enter his virtual “shooting gallery” they actually see a guy shooting up. And what could be more triggering to a heroin addict than that?
The basic idea is this: If you want to teach a recovering addict real world skills to use when he or she is triggered toward relapse, make the role play portion of treatment as realistic as possible!
Unfortunately, top of the line VR headsets are not cheap; the ones used by Bordnick run about $50,000 each. Plus, creating realistic virtual environments is both time consuming and tech-heavy, which adds to the expense. In other words, virtual reality is, as of now, cost prohibitive in most therapeutic environments.
That, however, is about to change. In fact, cardboard headsets that cost about $15 are already available to the public. Yes, cardboard. Essentially, you download an app with virtual environments onto your smartphone, you strap the phone into the cardboard headset, and suddenly you’ve got a pretty awesome VR setup. (I bought a couple of these headsets, downloaded a few environments – the Amazon jungle, outer space, and a few others – and played around with this, as did my partner and several friends. And it was awesome! (If you want to see what VR looks like and how real it seems to a user, check out Bordnick’s TEDx Talk, which has some great video of this experience at the 12:55 mark.)
Just as importantly, Dr. Bordnick is planning to make his virtual environments available for widespread, cost effective use in the very near future. This means that therapeutic role play is about to take a giant leap forward – hopefully within the next year or so.
Addictions overrun addicts’ lives on every level. They lose touch with friends, family, jobs, hobbies, and the real world in general, existing instead in a haze of obsession, planning, using, and feeling ashamed. As such, pretty much anything can trigger an addict’s desire to use. Think about a smoker trying to quit. This individual might be triggered by sex, eating, watching other people smoke, seeing an ashtray, feeling stressed, getting into an argument, having an unplanned five minutes with nothing else to do, etc. Needless to say, this is a significant part of why it’s so darn hard to quit smoking. (The other part is related to the chemical hooks with which tobacco is adulterated.) And it’s not just smoking that’s hard to quit. Other addictions are just as difficult to shake.
Because addictions are so all-encompassing, treatment must take an equally holistic approach to be fully effective. This means that technology must be incorporated into modern addiction treatment strategies. Parental control software products (discussed here), online meetings, digital support groups, recovery apps, and virtual reality all can and should be utilized whenever possible. In other words, technology should be used, in conjunction with other proven treatment techniques, to combat addiction in as many ways as possible. Holistic treatment for a holistic problem.
Robert Weiss LCSW, CSAT-S is Senior Vice President of National Clinical Development for Elements Behavioral Health, creating and overseeing addiction and mental health treatment programs for more than a dozen high end treatment facilities, including Promises Treatment Centers in Malibu, The Ranch in rural Tennessee, and The Right Step in Texas. He is the author of several highly regarded books, including Sex Addiction 101: A Basic Guide to Healing from Sex, Love, and Porn Addiction, and Cruise Control: Understanding Sex Addiction in Gay Men. For more information, please visit his website at robertweissmsw.com or follow him on Twitter, @RobWeissMSW.