This chapter discusses how virtual worlds (VWs) have been and are being used for the prevention and treatment of addictive behaviors related to substance abuse. The substances covered are tobacco, alcohol, and illegal drugs. By definition, physical health concerns the body but there is an indisputable physiological component to mental health (for example, vitamin D is related to depression). I suggest that embodiment – as a distinctive characteristic of VWs when compared to other virtual spaces (e.g.: chatrooms) - should present great potential for health professionals when considering VWs for the design of prevention or treatment health programs. VWs free users of time and space constraints. This further justifies the use of VWs as alternative or complementing spaces of intervention. The anonymity of these environments reinforces this idea, as addictions that were socially acceptable just a few years ago have become socially stigmatizing (e.g.: smoking). In the case of virtual worlds such as Second Life, anonymity is combined with embodiment, and this compounded effect, which is anything but simple, is particularly important for health professionals and health promotion advocates interested in exploring the use of virtual worlds in the treatment of substance abuse.
TopTerminology Used
Central to this chapter are notions of two very different disciplines: virtual worlds on one hand and substance abuse, on the other. So, I must clarify the terminology pertaining to both, very distinct, fields, before proceeding any further.
The term ‘substance abuse’ is used in this chapter as a synonym of a pattern of harmful use of any substance, whether natural or chemically prepared, for the purpose of altering one’s mood. Drugs are the main type of substance that drive abuse for purposes of mood alteration (Roberts & Koob, 1997). For purposes of this chapter, I will consider patterns of harmful use, for mood alteration, of alcohol, nicotine and illegal drugs.
For the term ‘ virtual world’, this chapter adopts Richard Bartle’s definition (2003) in his “Designing Virtual Worlds”, which is an excellent reference book on virtual worlds. Bartle makes a clear distinction between real, imaginary and virtual by noting that virtual is all that is not while having the effect or form of that which is. Bartle goes on to stress that since virtual worlds simulate environments, when different individuals can simultaneously affect the environment, the world is known as being a ‘multiuser environment’; and that the environment, however, continues to exist independently of being visited / occupied by individuals and so, and in most cases, it develops internally regardless of visitors and occupants. Bartle calls this property the ‘persistence’ of virtual worlds.
Bartle points out other features that most virtual worlds share: (1) a physics that is particular to the world (automated rules that allow users to impact the world); (2) interaction of individuals with the environment and other users of the environment is channeled through a character or representation of the self; (3) feedback to actions in the world takes place almost instantaneously. Furthermore the word is shared and (at least to some extent) persistent.