ABSTRACT Post-treatment substance use disorder (SUD) relapse rates are high (40-60% at one year), with relapse occurring early (median time to relapse 1-3 months), indicating that the transition period from inpatient care to the home environment is particularly challenging for patients seeking sobriety. Telehealth and VR technologies have the ability to greatly increase the accessibility of highly engaging recovery support. Combining these two approaches provides a unique opportunity to create a highly engaging, cost-effective take home recovery support solution targeting the critical transition from inpatient care. Sober Grid proposes to leverage its existing highly accessible social and peer coaching mobile recovery app, to develop a convenient and cost-effective integrated take-home combined VR and professional peer coaching recovery support intervention (RecoVRi) that begins in the inpatient clinic. RecoVRi is designed to increase engagement with recovery therapy during the critical transition from inpatient to home, thereby reducing the risk of relapse and associated health and monetary costs. Sober Grid is collaborating with TRIPP, Inc. to utilize TRIPP’s immersive wellness platform. The design of the TRIPP experience leverages a large body of existing research on the use of VR technology in the mental wellness arena and utilizes proven mindfulness structures, targeted sound frequencies, visuals and interactions that have a multiplicative effect when administered through immersion. The Sober Grid Network will create a support wrapper to the VR experience that facilitates access to crisis management experts and community for the person in early recovery. The unique combination of a personalized and targeted self-regulation toolkit and community and professional support is a key differentiator for this service. In phase I of the project, we will develop and pilot test a proof-of-concept RecoVRi VR-mindfulness protocol and intervention to ascertain feasibility and acceptability (Aim 1). In phase II of the project, a production-quality intervention will be developed with new VR content created by the TRIPP development team specifically targeting themes supporting recovery from alcohol, stimulant and opioid SUD separately (Aim 2). We will then test post-treatment recovery support engagement in the RecoVRi intervention in comparison to treatment as usual in a randomized comparison trial involving 80 patients receiving inpatient treatment and transitioning to the home setting (Aim 3). Over the span of both phases, we will seek regulatory guidance from the FDA in order to attain clearance for use of the RecoVRi intervention as a therapeutic medical device (Aim 4).

NARRATIVE Substance use treatment research findings indicate that the transition period from inpatient care to the home environment is particularly challenging for patients seeking sobriety. Sober Grid proposes to leverage its highly accessible social and peer coaching mobile recovery app to develop and test a convenient and cost-effective, integrated, take-home combined, virtual reality and professional peer coaching recovery support intervention (RecoVRi) designed to increase engagement with recovery therapy during the critical transition from the inpatient clinic to home.