More than 14 million adults nationwide report suffering from alcohol use disorder (AUD), but only a small portion of those people — 7.3% — ever get treatment, according to research published by JAMA Psychiatry. An even smaller percentage — 1.6% — receive medication-assisted treatment (MAT), which relieves the withdrawal symptoms and psychological cravings associated with AUD.
North-Star Care (NSC) — a virtual MAT provider focused on AUD — wants to change that. It’s tackling some of the most common AUD treatment barriers with the help of virtual reality (VR).
“It’s just a remarkable opportunity to think completely outside of the box, while keeping patients engaged and giving them tools over a longer period of time so that their brains can really heal and they have the support they need to do that effectively,” NSC CEO and co-founder Amanda Wilson told Behavioral Health Business.
Wilson started working on NSC about a year and a half ago, but it’s far from her first foray into the SUD treatment industry. Back in 2009, she founded CleanSlate Addiction Treatment Center, a brick-and-mortar outpatient MAT provider that currently has dozens of locations across 11 states. Then in 2015, she co-founded Boulder Care, a digital MAT startup.
She left those organizations in 2018 and 2019, respectively. Then, shortly after the coronavirus hit, she saw the opportunity — and need — to leverage VR in SUD treatment.
“We started talking to patients who, after COVID, were attending virtual groups,” Wilson said. “Sadly, they were just Zoom groups, where there were often more than 35 people in the room. Most of the people there didn’t feel comfortable speaking, and it didn’t feel anything like their in-person experience.”
And so Wilson and her colleagues started looking for solutions, ultimately settling on VR due to its immersive nature, as well as the accessibility and anonymity it allows for. To make it possible, the company partnered with Foretell Reality, which is a wholly-owned subsidiary of The Glimpse Group, Inc. (Nasdaq:VRAR), a VR and augmented reality platform company with several software and services subsidiaries.
“We are just one component in the very comprehensive program NSC put together,” Dror Goldberg, general manager of Foretell Reality, told Behavioral Health Business. “And that partnership helps us … to distill further the use cases that virtual reality can add value [in behavioral health].”
Those use cases are slowly but surely gaining traction, with some payers predicting that VR will be the next big game changer in behavioral health.
Meanwhile, Wilson is betting on the same: The company is launching its initial pilots in Michigan and Florida this fall, and it already has plans to expand NSC nationwide from there.
“Our hope would be to be in all 50 states probably within one to two years,” she said. “It may take up to three.”
In addition to using VR, NSC’s treatment program includes a smartphone app through which patients receive treatment, which is personalized to them and includes medication, therapy, medical care and more.
Initially, Wilson’s interest in adding VR to NSC’s toolbelt was strictly related to group therapy and support, which is a mainstay of most SUD treatment programs. She wanted to improve upon the weaknesses of the “Zoom model” and give patients more anonymity in the process
“We thought that group treatment in a virtual space, where the person is represented as an avatar, would give people the freedom to both participate in the first place, if they were reticent, but also the ability to really speak freely … and feel very comfortable communicating in this space,” Wilson said.
But now, Wilson said the potential NSC sees for VR is almost endless.
“There are more and more situations that we keep thinking VR could be a terrific solution for and radically change the experience both for the patients and, frankly, for the providers as well,” she said.
In addition to group therapy, NSC is also using VR for one-on-one peer sessions. Patients in different locations can virtually meet up for activities like ping pong, virtual golf or even a walk on the beach. The idea is that participating in a shared activity will make it easier for the peers to connect.
On top of that, NSC is exploring using VR to create informational rooms for patients and their family members. Those rooms would house a virtual library of resources on AUD, from educational videos to participatory activities.
VR can also be used for exposure therapy and EMDR treatment, Wilson highlighted, as well as to create environments that are much more calming and inviting than a typical therapists’ office.
Plus, it can be used to create virtual forums for patients, where they can build new relationships with peers facing similar struggles.
“How could we create this place where people could go at two o’clock in the morning, find someone else that’s actually struggling and just have a conversation?” Wilson said. “This enables us to provide 24/7 access [to support].”
When it comes to North-Star’s payment model, Wilson said the goal is to one-day provide care to everyone, from the commercially insured to those covered by Medicare and Medicaid.
“Rolling that out, from my personal experience with my other two [companies], it just takes time,” she said.
Still, NSC has a compelling case to make to payers: It offers an entire year of care for about half the costs of a 30-day stint in rehab, Wilson said. Plus, it’s making longer episodes of care — which lead to better outcomes — possible by virtue of its digital model. Wilson said NSC recommends that patients stay in the program for at least a year.
“If you look at the clinical data — and there’s abundant clinical data regarding treatment duration — it’s really clear that frankly 30 days is not enough,” she said, calling out the typical rehab time span. “The data shows it’s about a two to three year [recovery] process for most patients. … Realistically, you could not go away for a year and retain your life.”
Meanwhile, virtual care allows for year-long treatment episodes, while VR adds elements of three-dimensional engagement and privacy. Overall, Wilson said the model has the potential to revolutionize SUD treatment. Goldberg agreed.
“VR [has] a pivotal role [to] play in getting people behavioral health treatment,” he said.
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