Welcome to Back from the Abyss. I'm Dr. Craig Hecock.

Addiction is often understood as a downstream consequence of trauma, especially childhood

neglect or abuse.

And addiction clearly can also be the presenting symptom of an underlying psychiatric illness,

particularly depression or bipolar disorder, severe anxiety. This is classic self-medication,

using substances as a coping strategy to change or numb painful

emotional states. Sometimes, however, addiction is the main event, the core issue, the root of all

other emotional cognitive and interpersonal problems.

For Lena, her addictions were the root of all her misery.

She seemingly was born into this world with a brain precisely wired for drugs and alcohol,

and by sixth grade she was in high gear with no ability whatsoever to put on the brakes and stop the freight train of her addiction.

That Lena is alive today, the fact that she thrives today, is some kind of little miracle.

In the latter part of the episode, Lena and I discussed the key role that a medication

called Suboxone has played in her recovery.

Suboxone is the original brand name for buprenorphin, and I tend to use these interchangeably.

And those of you who listen to Desperately Not Seeking Meth in Season 1 might remember me

talking about Suboxone.

Suboxone is a medication that occupies the opioid receptor and partially activates it, thereby eliminating withdrawal symptoms and also providing a partial opioid effect,

including some relief of emotional and physical pain.

But Suboxone also has another very special property.

It is extremely sticky in the opioid receptor.

So long as a patient is taking at least 8 to 12 milligrams of Suboxone buprenorphine,

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