Researchers use virtual reality to help addicts kick heroin addiction

Clinical trial also looks at how to prevent people from becoming addicted

HOUSTON – Tucked away in a small room at the University of Houston is a cave. Inside this cave, researchers are using virtual reality to help addicts kick their heroin addiction.

Micki Washburn oversees day-to-day operations of the lab.

"I believe it is the first in the nation to investigate this technology around heroin and opioids," Washburn said. "This is very cutting-edge."

Addicts strap on a virtual reality headset and navigate through a house party scenario. Life-sized 3-D images are projected on the walls of the room. Details like an open pizza box or a spoon and syringe on a table are meant to enhance sensations and trigger a heroin craving.

"In this controlled environment, we're teaching them coping skills," Washburn said.

Luis Torres is the director of the center.

"If we tried to do this in the real world, going out into the street with them so that they can see the house where they last injected or see the people that last sold to them, or the people that inject with them, that poses some dangers," Torres said.

This virtual reality wouldn't replace traditional therapy, it would be in addition to it.

"If we can have multiple tools that can combat that addiction, we'll have a better chance for success," Torres said.

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Inside a small hospital just off the Southwest Freeway, more potential breakthroughs.

Dr. Harold Minkowitz is leading a clinical trial: How to prevent people from becoming addicted to opioids in the first place.

"What I've seen so far is amazing," Minkowitz said. "A recent paper came out in JAMA this year, which showed 6 percent of people after minor or major surgery are still using opioids three months out, so it's a problem. People are being given this opioid post-operatively, taking them home and becoming chronic users."

In fact, opioid addiction can start in as little as seven days. So Minkowitz is testing out a potential miracle solution in the operating room, during extreme surgeries, like a tummy tuck.

"During the surgery, patients are given opioids. It's a very traumatic, a very large operation. But after the surgery ends, this special goo is placed over the wound, then the wound is closed up. Then the patient goes off to the recovery room," Minkowitz said. "The opioid use ends once the patient leaves the operating room."

Mary Hernandez had her tummy tuck with the goo in December, right before Christmas.

"Post-op after we went home, I didn't actually need any medication," Hernandez said. "The results were really good. There was minimal pain."

In a double-blind study, there is a placebo group and a control group. Hernandez and Minkowitz didn't know who was in which group, but Minkowitz feels so far, the results speak for themselves.

"When I first saw her and some other patients in the study after in the recovery room, I thought maybe they had the wrong surgery. I thought they were too comfortable," Minkowitz said. "They all could've been placebo, but the response was so dramatic that it was pretty amazing."

Trials and research can take years to prove effective, so Houston is on the forefront of a more immediate remedy.

Dr. Rosalyn Morales is training the next generation of nurse practitioners.

"Unfortunately, addiction is not specific to any certain individual," Morales said.

At the University of Houston Nursing School in Sugar Land, students are learning the standard CDC guidelines, but Morales goes above and beyond that.

"I tell my nurse practitioners that how they prescribe makes a difference in how the patient feels, but you can also prescribe and make the patient worse," Morales said.

The philosophy is to take care of the patient as a whole.

"Not only their physical needs, but their mental, psychological and spiritual needs," Morales said. "Sit and listen, because sometimes that's all it takes."

For student Hilary Butella, she felt a "calling" to help others at a young age.

"I was always the one taking care of my pets and playing nurse with the baby doll," Butella said.

She's learning about building a relationship.

"In a program like this, we're trained to recognize that it exists and to be able to screen patients," Butella said. "We identify these patients and treat them holistically to prevent an opioid addiction. We refer out for physical therapy, massage, acupuncture, those sorts of things. If a patient requires pain management we want to do something on a short-term basis that has a lower risk for abuse."

And educating her patients.

"One thing we would see in the ER were overdoses and it was troubling to me," Butella said. "People would keep surgical pain medications and then their kids can get into the medicine cabinet. So we work a lot on patient education and locking up your medicines and when you're done with your prescriptions, you can take it to a pharmacy and they can dispose of it."

The pharmacist also has crucial role in the opioid epidemic.

Stephanie Crowley is training at the University of Houston's Pharmacy College.

"If there is something fishy about the prescription itself or they just don't feel comfortable, it's up to that pharmacist's clinical judgment to fill it or not fill it," Crowley said.

A big part of her study is learning about Texas's new drug monitoring program.

Dr. Marc Fleming teaches at UH and is a big advocate of the program.

"Pharmacists and physicians alike, they can put patient information in and access all their controlled-substance prescription history," Fleming said.

The program launched in Texas in 2012, but recently, the state pharmacy board took over the program.

Now more pharmacists are using it, and starting in September 2018 it'll be mandatory.

"I view it as a lifesaving tool," Fleming said. "It's one thing to have a hunch about what you think is happening with the patient. It's another to look at the data right before you where you can see the patient and oh, they've been to eight different doctors. They've been to 20 pharmacies in the past six months."

From there, pharmacy students are taught they can use that opportunity to intervene with the patient and find out what's really going on.

"Do they have an opioid addiction? Are they selling these drugs? Are there mental health issues that are not being addressed?" Fleming said.