Gamification of treatment and exposure to positive feeling states via virtual reality in substance use disorder: A literature review

Virtual reality (VR) is emerging as a promising treatment modality for substance use disorder (SUD), offering repeatable, customizable therapeutic exposures difficult to replicate in traditional clinical settings. Despite growing interest, the combined potential of VR-delivered positive feeling states and gamification of SUD treatment remains underexplored.

Conventional SUD treatment often fails to engage patients over time, contributing to high dropout and relapse rates. Gamification has demonstrated potential for improving motivation and treatment engagement. Separately, exposure to positive feeling states such as love, joy, and peace may counteract the reward deficits central to addiction. VR presents a unique platform for delivering both interventions in a controlled, immersive environment.

A structured literature review will be conducted examining peer-reviewed research across four areas: (1) the effect of positive feeling states on SUD treatment outcomes; (2) the efficacy of gamification in SUD treatment; (3) the use of VR in SUD treatment; and (4) the use of VR as a vehicle for delivering positive feeling states and gamified treatment experiences to individuals with SUD.

Evidence suggests that exposure to positive affective states is associated with reduced craving and improved treatment engagement. Gamification strategies have demonstrated increased motivation and therapeutic participation. VR has shown efficacy in cue-exposure therapy and early evidence supports its capacity to induce positive affective states and immersive reward experiences.

VR represents a novel platform for advancing SUD treatment through exposure to positive feeling states and gamification of therapeutic experiences. Future research should include randomized controlled trials to establish efficacy and inform clinical implementation.

VR-based interventions combining gamification and positive affect induction offer clinicians a novel, evidence-informed tool to improve engagement and retention in SUD treatment. Addiction professionals should consider how immersive technology can complement existing therapeutic frameworks to address the reward deficits underlying substance use disorder.