The episode title is a play on the phrase "virtual insanity", a reverse reference to "virtual reality".
The horn in Roger's limo blares "Dixie" in the style of the General Lee on Dukes of Hazzard.
The bowling team "Lanes Addiction" is a reference to the rock band Jane's Addiction.
When Roger kills the thug in the bathroom, a mixture of blood of water goes down the shower drain, a reference to Alfred Hitchcock's Psycho. Also, before the guy dies, he's reading a magazine that says Maxum, a parody of Maxim.
Francine's lift mecha contains elements from the film Aliens and Avatar. Francine also parodies Sigourney Weaver's line from Aliens when she tells Phyllis to "Get away from him, you bitch". Coincidentally, both Avatar and Aliens were directed by James Cameron.
Roger killing the kids contains elements from the films The Car, Christine and the Final Destination films.
The CIA lab doors imitate the sounds of doors opening and closing in Star Trek.
The DVD commentary credits the television show The Wonder Years as the inspiration for the home movie montage of Steve growing up.