Enhancing Prospective Thinking in Early Recovery (PARK) (PARK)

The goal of this clinical trial is to demonstrate the commercial potential for a novel virtual reality (VR) intervention in preparation for Phase II development. This clinical trial will test the VR intervention for efficacy in reducing opioid use, increasing abstinence, and other self-reported and behavioral focus on future outcomes in individuals in early recovery from opioid use disorder. Will the VR group, compared to the control group, have a lower number of opioid use days? Will the VR group, compared to the control group, have longer periods of abstinence at the 30-day follow-up? Will the VR group, compared to the control group, have significantly increased opioid abstinence rates? Will the VR group, compared to baseline and the control group, show increased future self-identification post-VR intervention? Will the VR group, compared to baseline and the control group, show increased future orientation post-VR intervention? Will the VR group, compared to baseline and the control group, show an increased preference for delayed rewards in a laboratory delay discounting task post-VR intervention? Will the VR group, compared to baseline and the control group, exceed in behavioral effects (i.e., future self-identification, future orientation, and increased preference for delayed rewards) at the 30-day follow-up? Researchers will compare the VR test group and the control group to see if there are differences in the results for the questions outlined above.

All study participants are randomly assigned to a group prior to study enrollment. Participants will not be made aware of their group assignment.

Participants in this arm will receive the following interventions: Treatment As Usual (Empty Virtual Reality Park) Virtual Reality Avatar (Intervention)

Participants in this arm will receive the following interventions: Treatment As Usual (Empty Virtual Reality Park)

In the Virtual Reality Avatar Intervention experience, participants will see an avatar resembling themselves in a park setting. The Virtual Reality Empty Park experience is a habituation experience that does not contain avatars.

The VR Avatar experience, compared to treatment as usual will change abstinence, measured using a timeline follow-back assessing for substances used from enrollment to study completion.

The VR Avatar Experience will change future self-identification. Future self-identification and change between two time points will also be measured using a proprietary future-self-continuity assessment administered at Study Day Visit (Day 1), and again at the 30-Day Follow-up Visit.

The Virtual Reality Avatar experience will change orientation toward the future, which will be measured using the Zimbardo Time Perspective Inventory (ZTPI). The ZTPI contains five subscales, and items within each subscale are scored from 1, "very uncharacteristic," to 5, "very characteristic." The subscales are 1) Past-Negative--10 items, higher scores indicative of worse outcomes; 2) Present-Hedonistic--15 items, higher scores indicative of worse outcomes; 3) Future--10 items, higher scores indicative of better outcomes; 4) Past-Positive--9 items, higher scores indicative of better outcomes; and 5) Present-Fatalistic--9 items, higher scores indicative of worse outcomes. Subscales are combined into "future" and "present" categories, then totaled, with higher total scores indicative of worsened outcomes.

The Virtual Reality Avatar experience will change preference for delayed rewards, which will be measured using a behavioral delay discounting task.

Inclusion Criteria: Abstinence between ≥14 days and ≤ 1 year 18-60 years old Verbal endorsement of commitment to recovery Outpatient Psychotropic drugs for SUD-comorbidity Mu-Opioid drugs Drug/alcohol abstinence ≥ 24 hours at the time of the study day visit English comprehension Exclusion Criteria: Unstable medical disorders Outside the age range of 18-60 Habitual drug use Smell/taste disorders Unstable psychiatric conditions Extravagant/elaborate face tattoos

The IPD will be shared in accordance with the National Institutes of Health National Data Archive requirements and upon the consent of the study participant.

Data will be shared at the specified submission deadlines assigned by the National Institutes of Health (typically every April or October). Data will be available upon the discretion of the National Institutes of Health.

No individually identifiable participant data will be submitted to the National Data Archive. All collected participant data is de-identified, and will be made available for other researchers to use upon requests submitted through the National Data Archive portal, and approval from the principal investigator.