What is it?
Interventionville is an innovative virtual reality application that helps people recovering from addiction to explore different addiction treatment options. The application allows patients to explore treatment options in a relaxed, picturesque virtual village while in clinic or hospital. Providing the patient with a near firsthand, visceral experience of what different treatment options will be like better enables them to choose the one best suited to them. This increases the chances that their addiction treatment will be a success and helps them to remain sober and healthy.
How is it different?
Using the latest innovations in virtual reality from the gaming industry, Interventionville allows users to experience three types of mutual help meetings:
- 12-step meeting (similar to AA or NA)
- Buddhist-based meeting (similar to Refuge Recovery)
- Cognitive behavioral therapy-based meeting (similar to SMART Recovery)
Additionally, users can see what it’s like to have a consultation with an addiction medicine specialist within the Interventionville app. They can also learn more about the science and treatment of addiction, in a relaxing and visually appealing environment, which uses gamification techniques to keep the user engaged. After experiencing each of the meeting types in the immersive VR environment, the app user can pursue the one they liked best in real life.
What is it?
Opioid Harm Reduction App (OHRapp) is a mobile app which will connect opioid users with carriers of naloxone in their community. According to the Centers for Disease Control and Prevention (CDC), there were 63,606 deaths from opioid overdose in 2017. That’s a shocking 174 deaths each day. To put this in perspective, this is the equivalent to a passenger jet crashing each day, and is more than all the Americans soldiers killed in combat during the Vietnam War.
Jerome Adams, the Surgeon General of the United States, has stated that knowing how to use naloxone, and keeping it within reach, can save lives. Access to naloxone is important for patients taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, and individuals using illicit opioids such as heroin or fentanyl. It is also important for healthcare practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose.
How is it different?
OHRapp will create the largest and safest network of naloxone carriers, accessible via the mobile app. It will only become functional once a certain threshold of users is met (estimated at between 50,000 to 100,000 users in the US). OHRapp will augment the current EMS network by allowing community members with naloxone to respond to emergency requests for it. All of our naloxone carriers will undergo background checks, and each time a lot of naloxone is registered the serial number of the medication will be verified.
OHRapp will utilize a “freemium” model, with both a free and paid subscription version. The paid version of OHRapp will offer the ability to connect to a Bluetooth pulse oximeter, so a request for naloxone can be sent automatically if the user is alone and a decrease in blood oxygenation (indicating a possible overdose) is detected.
Our mission is to improve the lives of people affected by addiction using digital health technologies. We will partner with leading academic institutions to rigorously optimize and test our products before making them available for use in a variety of clinical settings. Our experienced team is developing innovative solutions to complicated problems that affect nearly every community around the world.
Matthew Prekupec, MD – Founder
Dr. Prekupec is a board-certified Internist with a special interest in Addiction Medicine. He completed medical school at St. George’s University and residency in Internal Medicine at the University of Nevada – Las Vegas. He has published numerous peer-reviewed articles including “Misuse of Novel Synthetic Opioids: A Deadly New Trend“ which was cited in The President’s Commission on Combating Drug Addiction and the Opioid Crisis. He is an executive member of the Nevada Society of Addiction Medicine and a past member of the VRARA Digital Health Committee. He was awarded the Ruth Fox Memorial Endowment Scholarship in 2017 and is currently studying at the Bloomberg School of Public Health at Johns Hopkins University for part-time MPH. When not working on digital health applications, he spends time working as a hospitalist at the VA Medical Center of Southern Nevada and has received an award for outstanding resident teaching.
Peter Mansky, MD, Member, Scientific Advisory Board (In Memorium)
Dr. Mansky had an illustrious career in Psychopharmacology and Addiction Psychiatry spanning over five decades. He trained at SUNY Buffalo Medical School before completing research fellowships at the NIMH Addiction Research Center and the University of Illinois. He then went on to complete Psychiatry residency and fellowships at Harvard’s Massachusetts General Hospital. He published more than 40 peer-reviewed articles and gave over 130 national and international presentations. Professionally, he will be most remembered for his contributions to the field of physician health. As an advisor, he always made himself available and his ideas and feedback were crucial for the development of the 12-step simulation in Interventionville.
Dr. Mansky was a past President of the Federation of State Physician Health Programs and was the founding Chair of the Physician Health Committee for the American Academy of Addiction Psychiatry. Until his passing in August 2018, he continued his academic interest as an Associate Editor for Psychiatric Quarterly, Member of the Editorial Board of the Journal of Addictive Diseases and as a Professor of Psychiatry, Addiction, and Physician Impairment at Touro University (Nevada).
We are currently developing partnerships with leaders in academia and industry in the fields of addiction, digital health and virtual reality. We will provide more information as these relationships become more formalized.
Article introducing Drs. Lembke and Mansky as advisory board members.
VRARA: VR and AR in Healthcare May 11, 2018
Article discussing how Order 66 Labs and other VRARA members are using VR and AR to improve healthcare.
No upcoming events
Order 66 Labs was proud to sponsor this event which brought together a panel of leaders to discuss the use of virtual reality as a story telling medium.
Order 66 Labs was proud to sponsor this event which brought together a panel of leaders to discuss use cases of virtual reality in healthcare.
3rd Annual Innovations in Psychiatry and Behavioral Health: Virtual Reality and Behavior Change October 6-7, 2017
Order 66 Labs team attends to learn about the latest research in VR and Psychiatry.
Health 2.0 11th Annual Fall Conference October 1-4, 2017
Order 66 Labs team attends to learn about digital health innovations and was selected to participate in the Startup/Investor Breakfast.
Mutual Help Groups:
Sisson and Mallams (1981). The use of systematic encouragement and community access procedures to increase attendance at Alcoholic Anonymous and Al-Anon meetings.
Shows 0% versus 100% of subjects attending a meeting in the standard versus intensive referral. Not only did they attend the initial meeting, they followed up with an average of 2.3 meetings over the next 4 weeks. However, small sample size.
Blondell et al. (2001). Can recovering alcoholics help hospitalized patients with alcohol problems?
Shows differences in abstinence rates for standard care, brief intervention and peer intervention at 6 months rates are 9, 15 and 49% respectively. Larger sample size of 300+.
Humphreys and Moos (2001). Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study.
Compares 12-step meetings versus cognitive behavioral therapy in a clinic. Twelve-step has higher abstinence, less inpatient days and total healthcare savings of $4700 per patient per year.
Saitz et al. (2014). Screening and brief intervention for drug use in primary care: the ASPIRE randomized clinical trial.
Shows brief interventions with illicit drug users in a primary care clinic are not effective.
Zemore et al. (2018). A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with Alcohol Use Disorder.
Study of various 12-step group alternatives suggests that alternative groups can be as effective as 12-step if baseline motivation is equal.
Seyama and Nagayama (2007). The Uncanny Valley: Effect of Realism on the Impression of Artificial Human Faces.
A study the effects of increasing human face realism on perceived pleasantness relating to robots and VR avatars.
Ma et al. (2014). Virtual, Augmented Reality and Serious Games for Healthcare 1.
A collection of full-text scholarly articles introducing theory, development and applications of VR and AR for healthcare.
Riva et al. (2016). Transforming experience: The Potential of Augmented Reality and Virtual Reality for Enhancing Personal and Clinical Change.
This is an extremely helpful review of reviews on the clinical applications of VR and AR to various behavioral health conditions.
Tanja-Dijkstra et al. (2017). The Soothing Sea: A Virtual Coastal Walk Can Reduce Experienced and Recollected Pain.
Study showing that a VR simulation of a coastal environment reduces pain while that of an urban environment does not.
Rizzo and Koenig (2017). Is clinical virtual reality ready for primetime?
Review and opinion piece by two leaders in clinical VR outlining why they think clinical VR will become an indispensable tool in the practitioner’s toolbox of the future.
Bailenson (2018). Experience on Demand: What Virtual Reality Is, How It Works, and What It Can Do.
A light yet very informative read by the professor that Mark Zuckerberg sought advice from prior to Facebook buying Oculus in 2014.
Riva et al. (2019). Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine.
Excellent meta-review of studies done on VR in behavioral health.
Shin et al. (2019). The uncanny valley: No need for any further judgments when an avatar looks eerie.
Newer study looking at the uncanny valley effect on VR avatars.
CDC (2016). Guideline for Prescribing Opioids for Chronic Pain.
Prescribing guidelines which state for patients being prescribed opioids for chronic pain those with history of overdose, substance use disorder, taking greater than 50 MME/daily or concurrent benzodiazepine therapy, that a naloxone prescription should be considered.
McDonald and Strang (2016). Are take-home naloxone programmes effective?.
Review showing that take-home naloxone reduces overdose mortality among program participants and in the community while having a low rate of adverse events
Clangham et al. (2017). Cost-Effectiveness of Take-Home Naloxone for the Prevention of Overdose Fatalities among Heroin Users in the United Kingdom.
Study from the UK showing that take home naloxone is more than 20 times more cost effective than the threshold which their decision makers seek as a minimum for an intervention they’ll pay for.
Adams (2018). Surgeon General’s Advisory on Naloxone and Opioid Overdose.
Advisory by the US Surgeon General urging expanded awareness and availability of naloxone.
Grace et al. (2016). Morphine paradoxically prolongs neuropathic pain in rats by amplifying spinal NLRP3 inflammasome activation.
A basic science article which shows just a few days of morphine is enough to induce long-lasting chronic pain.
Prekupec et al. (2017). Misuse of Novel Synthetic Opioids: A Deadly New Trend.
A review article outlining the rise of illicit fentanyl and other synthetic opioids among drug users.
The American Society of Addiction Medicine defines addiction as “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
Drug overdose is the leading cause of accidental death and has skyrocketed in recent years due to the rise in the illicit use of synthetic opioids. It is estimated that 45% of Americans personally know someone who has been addicted to opioids. Excluding tobacco, costs of alcohol and drug use approaches $600 billion per year annually in the United States alone.
Addiction is not just some remote concept in movies with the addict living in the streets, robbing and selling their body to get their next fix. Addiction is a common disorder that most likely affects one of your family members, friends or colleagues, and left untreated it results in disability or early death.
There are two ways VR environments are created. One way is to use a special camera that captures video in 360 degrees, and then the user can watch the video and turn their head as though they were there. The disadvantage with this approach is that it offers poor depth and is less immersive. The better way is to create a fully rendered VR environment, where the entire world is computer generated and you can move through it freely and interact with objects in the world (as allowed by the programming).