The United States is facing a drug dependency epidemic. In 2016 there were more than 64,000 overdose deaths – a rise of over 22% on the previous year.

Many of these deaths involved opioids – the family of drugs that heroin and morphine belong to. But new research shows that there may be a much less harmful way of dealing with chronic pain: virtual reality.

Image: REUTERS/Fabrizio Bensch

The pain problem

Image: CDC

Source: CDC

Chronic pain is a major public health problem in advanced economies, particularly in the USA and Canada.

Opioids are widely prescribed to help patients, but they’re also causing drug addiction and a heavy toll of overdose deaths.

In the US, overdose deaths involving prescription opioids have quadrupled since 1999. Between 1999 and 2015, more than 183,000 Americans died from overdoses related to prescription opioids. In 2012, more than 250 million opioid prescriptions were written in the US. Part of the problem is that the effectiveness of the drugs diminishes over repeated use.

Virtual reality as pain relief

Image: Firsthand Technology

Source: Firsthand Technology

However, virtual reality has been shown to help reduce pain. In a recent study, 30 participants with various chronic pain conditions were offered a five-minute session using a virtual reality application called Cool!

Cool! is the invention of Firsthand Technology, a US-based company that wants to use VR as a way to improve health and wellness.

The game arms the player with a bubble launcher and a ‘rainbow trout cannon’ to fire a paintball at a giant otter. The landscape of the game is bright and colourful, with elements such as dancing flames in crystal caves.

Participants rated their level of pain before, during and after the session. And overall, the researchers found that it was reported as a third less (33%) at the end. During the session the pain had lessened by two-thirds (66%). That’s more than the effect of morphine, which reduces pain by an estimated 30%.

Three of the patients said they felt no change after the session, but that their pain had diminished whilst playing the game. Ten patients said they felt no pain at all while immersed in the virtual reality session.

The patients all used a head-mounted display (HMD) and did not report any side effects.

Despite admitting that there were “several limitations to this study” the authors concluded that virtual reality showed promise as a non-opioid treatment for chronic pain and further investigation was warranted.

How does it work?

Although the authors of the study couldn’t pinpoint the exact reason why VR brought about pain relief, they surmised that it was the fact that patients’ attention was focused on the game, and that the game brought about feelings of joy.

Image: Stephen Dagadakis

In another study in 2007, researchers tested VR on burn patients. When these patients undergo wound care they experience excruciating pain. In this experiment, patients took their normal painkillers, but also entered a virtual reality game called Snowworld, a game specifically designed for those with burn pain. Patients were asked to rate their pain, as well as undergoing brain scans.

The participants reported a 20% reduction in pain, and a 37% reduction in time spent thinking about the pain.

The researchers said they believed that it worked because “pain requires conscious attention. Being drawn into another world drains a lot of attentional resources, leaving less attention available to process pain signals”.

Image: Hunter Hoffman

In another study, published in The Lancet in December 2016, researchers were able to reduce phantom limb pain – where an amputee still feels pain from the absent limb – by almost half, using virtual reality.

Lead author of the study, Dr Max Ortiz-Catalan, believes the reason is a "retraining" of the brain, telling CBC that: "We demonstrated that if an amputee can see and manipulate a 'virtual limb’ – which is projected over their limb stump – in space, over time, the brain retrains these areas. Through this retraining, the brain reorganizes itself to focus on motor control and less on pain firing."

Problems with VR

Virtual reality is not without its problems. As more and more people use the technology, a big problem has emerged: motion sickness. VR causes nausea in some people, just as a rocking boat might.

One study undertaken at Leeds University in the UK found that virtual reality headsets could put children’s health at risk. A 20-minute game risked vision and balance problems for players aged eight to 12. Long-term effects of virtual reality use need more research, say scientists.

But a remedy for chronic pain is urgently is needed. Just last month, President Trump officially made opioid addiction in the US a public health emergency. Whilst the studies of VR as pain relief are small, they offer hope to the millions of people using addictive drugs to treat chronic pain.