A Country Doctor Writes:

We do two things when we treat young adults with opioid use disorder in our Suboxone clinic.

The obvious one is providing the chemical that attaches to certain opiate receptors and quiets cravings without feeding the reward cycle.

Because buprenorphine is also a Kappa antagonist, it has antidepressant and anxiolytics properties that traditional opioids don’t have.

By prescribing Suboxone, we help our patients’ brains return, partly or completely, to the way they functioned before they became habituated to opioids.

The other thing we try to do, although it isn’t just our job, but that of everyone who cares about a young adult in recovery, is habilitation.

Habilitation isn’t relearning what you used to know, but acquiring skills you never had in the first place.

We generally say that your emotional and character development stops when you become addicted. It can also arrest when you suffer trauma. The life lessons of cause and effect, immediate and delayed gratification, giving and taking, joy and sadness, self and community are all skipped over to some degree when you are on a chemical roller coaster or suppressed by the weight of emotional trauma.

In our group therapy, facilitators and participants challenge newcomers who feel the world owes them things they haven’t earned. We talk about sticking with a job you don’t like to build a resume for better jobs in the future. We talk about proving to the DHHS that you can be appropriate and responsible with your children. We talk about making new social contacts and friendships, developing new interests and about coping with stress, emptiness and disappointment.

We have also started a group for friends and families of people in recovery. This group, aided by veteran Suboxone patients, serves as a sounding board for our journey. Because it isn’t a paved highway – the prescription part is pretty straightforward, but the other part is different for every patient, every group and every community. It must be local, a grassroots effort.

A lot of interest and a lot of money is flowing into opiate dependence treatment right now, mostly the chemical part.

But once that happens we must face the next big challenge, which isn’t talked about much yet, of helping a large cohort of young adults catch up from a decade or two of skipping classes in the school of life.