Exploring the relationship between cue-induced craving and withdrawal craving in MUD individuals based on a virtual-reality cue exposure paradigm

Abstract

Background: This study developed a virtual reality (VR) drug cue exposure paradigm for individuals with methamphetamine use disorder (MUD) to investigate the characteristics of withdrawal craving and cue-induced craving and their relationship. Methods: A total of 150 male participants diagnosed with MUD completed questionnaires to assess their demographic characteristics and substance addiction profiles. Withdrawal craving for methamphetamine (MA) was measured using the visual analogue scale (VAS). VR technology was utilized to expose participants to three types of scenarios: neutral scenes, MA-related paraphernalia, and drug-use scene, while cue-induced craving in different scenes was assessed using the VAS in VR environment. Results: The results showed that:1) In the VR cue environment, MUD participants’ craving in the drug use scene was significantly higher than in the neutral and MA paraphernalia scenes (p < 0.001) and significantly higher than the pre-exposure withdrawal craving (p < 0.05). 2) Withdrawal craving scores were positively correlated with craving scores in all three VR scenarios (p < 0.01). 3) Both withdrawal craving and cue-induced craving scores were positively correlated with the total score of the MUD severity scale (p < 0.05). Withdrawal craving scores were positively correlated with MA use dosage and abstinence duration (p < 0.05). Conclusion: These findings suggest that the VR-based cue exposure paradigm can serve as an effective tool for assessing MA-related cue-induced craving. By identifying specific scenarios that elicit strong craving responses, this study provides a foundation for designing immersive VR therapies that can reduce craving and prevent relapse, potentially enhancing treatment outcomes for MUD. It contributes to a deeper understanding of the roles of withdrawal craving and cue-induced craving in the addiction process and their interrelationship.