hang Hailang (pseudonym) was focusing intensely on a video depicting several people who had gathered in a hotel to take crystal methamphetamine. The flame from a cigarette lighter transforms the crystals in a glass pipe into gas with a rumble, before the man holding the pipe inhales the vapor, a look of great satisfaction crossing his face.
Zhang is a drug addict. The video ends, he takes off his virtual reality (VR) headset and begins to chat with the staff at the drug rehabilitation center in Liangzhu, Zhejiang province, where he is a patient.
NewsChina was granted access to China’s first VR-based drug rehabilitation program for methamphetamine addicts. The Zhejiang Provincial Drug Rehabilitation Management Bureau and Seventh Technology, a private IT company, developed it. Distinct from heroin, to which drug users experience a predominantly physiological dependence, methamphetamine addiction is primarily a psychological craving. But that doesn’t make it any easier to kick.
A form of aversion therapy, the video clips depict both pleasant and unpleasant drug use scenarios, with the latter showing the detrimental impact on the users’ lives. Patients’ pulses and heart rates are taken before and after they watch the videos, and after the treatment, to generate objective data for later analysis.
According to Wang Yongguang, who works with the provincial rehabilitation management bureau that helped pioneer the therapy, the method reduced the cravings of 75.8 percent of the methamphetamine users admitted to the facility. “That doesn’t mean 75 percent of addicts have abandoned addiction though,” he said.
The VR-based drug rehabilitation program is now in use in four rehabilitation centers around the province, and other regions have expressed their interest.
Getting to Know the Users
Wang spent many months this year in drug rehabilitation centers in Zhejiang, where he spoke with around 600 drug users to learn how they became addicts. Meng Jiayun, a senior manager in the technology company that provided the VR system, has also interviewed nearly 300 drug users. Their experiences informed the VR content they later made.
There are three types of videos. The first allows drug users to experience scenarios similar to those that trigger their drug cravings, such as in a party scenario. The second video – a form of aversion therapy–shows people experiencing dizzy hallucinations, frantic and painful cries, and even maggots gnawing at their bones. Scenes where drug users were arrested by police after a break-in are also included in the videos.
“Some drug users choose to close their eyes, but the sound stays on and it is even more horrific. Closing their eyes during the treatment is useless,” Wang told our reporter. “This is the initial step. We employ acoustic and visual stimuli to trigger empathy and we are likely to stimulate other senses including touch and smell in the future.”
The third video, however, shows beautiful scenery, people in a park and appetizing meals at home. Scenes of relaxing, warm family moments are presented to encourage drug users to reflect on what they have missed because of their addiction. Zhang Hailang’s five-year-old daughter once came to the rehabilitation center to give him emotional support. Zhang’s wife had planned to divorce him but later said the family would await his return. All these moments have been added to the videos.
It usually takes two months to watch all three types of videos as a course of treatment. During the period, drug users have to watch each video six times. “Every time, drug users are exposed to at most five minutes of the video because it will make them uncomfortable if it goes on for any longer,” Wang said.
Scenario Reproduction
At drug rehabilitation centers across Zhejiang, drug users receive at least two years of treatment in four phases. These are physiological detoxification, adaptation, recovery, and final instruction. The phases can be compared respectively to wards, army camps, campuses and residential communities.
In January 2017, Zhang underwent physiological detoxification shortly after he was admitted to a drug rehabilitation center. Three or four addicts shared one bedroom, and they had to weather great bodily discomfort. All they could do to get by was sit quietly, sing, and recite regulations and rules.
One year later, they moved to a dormitory shared by 12 inmates. During this period they underwent physical training in a courtyard, as well as VR-based rehabilitation therapy. They were required to wear at least three chips around their wrists and arms to record the variations in their heart rates when they watched the videos.
None of the staff at Seventh Technology says they have ever seen drugs personally, but their videos need to be as realistic as possible. They have hired several professional actors and a former drug user to help achieve this aim.
“We made all the drug-taking paraphernalia ourselves after reporting to the police, who participated in the whole filming process,” Meng Jiayun told NewsChina. “The most crucial part of acting is gestures and jargon.” All actors were required to sign a confidentiality agreement and were not allowed to use their phones throughout the process.
Meng said his company had invested nearly eight million yuan (US$1.2m) in actor recruitment and equipment to date. His team is preparing to shoot new videos, he said.
Tracking Plan
Wang Yongguang says the VR therapy is based on the principle of Pavlov’s conditional response. “We aim to help drug users turn their reliance on drugs into hate and fear of drugs before a conditional response is established,” he said.
Some drug addicts told our reporter that they had no feelings at all after watching the videos of drug-taking, the pain of rehabilitation, or dramatic arrests. Wang argues that if there is no heart rate variation at all, it means the patient is cured. He said VR treatment is mainly used for methamphetamine addicts because it is easy for them to quit the drug physically, but not psychologically.
“It is not a cognitive therapy. That would lead to a fundamental change in their conceptualization of drug use. But we have taken a different approach by setting up a simple conditional response to extract the memories of drug users and combine them with malignant consequences,” he said.
What’s more, Wang claims that female drug addicts are more averse to videos showing the detrimental impact of drug use, and says his research team will follow up to study individual differences and the psychological endurance of drug users. Seventh Technology explained that different video modules have to be filmed in the future to improve its effectiveness for various groups of patients.
Zhang Hailang had tried to break free from drug addiction several times before he was sent to the rehabilitation center. But he always relapsed. Statistics from China’s National Narcotics Control Commission show more than 85 percent of those who abandon drug habits after two years of mandatory rehabilitation will relapse within a year.
“Many factors lead patients to relapse. The VR therapy has proved effective in cutting the proportion of relapsing users,” Wang said, adding that 75 percent of drug addicts using the VR therapy showed markedly lower cravings. In comparison, only three percent of patients showed a lower desire for drugs in a group that did not receive VR therapies.
The first group of drug addicts exposed to VR therapies has now left rehabilitation. Wang told NewsChina that a VR-based assessment and rehabilitation database had been established based on tests of more than 1,000 people. From 2018, his team will track the lives of 1,000 people who have overcome drug addiction.
“After a while, drug users’ memories of the VR videos will fade away,” he said. “We will find another indicator to gauge when it is appropriate to reduce their drug cravings again.”
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