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Stage
Childhood Years
Sally feels neglected after her parents' divorce and struggles with their substance use. She faces depression, bullying, and social pressure, leading her to use drugs. After a family member's overdose leaves her isolated, she turns to self-medication and becomes involved with heroin and fentanyl, finding herself in a tough cycle.
1. CINGULATED CORTEX
  • Involved in processing emotions and behavior regulation
  • Plays a role in cognitive functions such as decision making and error detection
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Stage
Teen Years
Sally considers treatment but finds it difficult to access. After an overdose, Emergency Medical Technicians (EMTs) revive her with Narcan, leaving her scared, panicked, and in pain from withdrawal. Taken to the emergency room, she fears relapsing.
1. MEDIAL PREFRONTAL CORTEX (mPFC)
  • Integrates sensory and emotion information from limbic system
  • Regulates emotion and expression, delays immediate gratification for larger reward
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We'll now explore three roads to recovery that Sally could take. Each road represents a unique continuation of Sally's story. Like a 'choose your own adventure' book, these paths show how different choices, circumstances, and interventions can shape the recovery process.
Click on one of the roads below to see how Sally's journey unfolds from here.
We’ll now explore Sally’s journey through Road 1.
Stage
Maintenance Stage
Following her turbulent childhood, Sally goes to drug court and is encouraged to go into addiction recovery. However, she begins selling her prescribed medications for opioid use disorder (MOUDs) and eventually relapses. Continuing in her journey Sally begins attending support group meetings.
1. MEDIAL PREFRONTAL CORTEX
  • Chronic exposure to stress and trauma during childhood led to neuronal loss in MPC
  • Impairs cognition and impulse control - predisposed to substance use
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Stage
Challenges and Setbacks
Sally is able to graduate from drug court. However, recovery is a long process, and it certainly isn’t easy. Self-doubt gets to her, and she tells herself she doesn’t deserve good things. She begins isolating herself, eventually selling drugs, which culminates in yet another relapse.
1. PREFRONTAL CORTEX
  • Impaired top down regulation in PFC favors continued addictive behaviors
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Stage
Long-term Recovery
Despite challenges, Sally is determined to get better. She is working to change her people, places, and things. She begins attending support group meetings again. Here, she is relieved to have a support network, feels less lonely, isolated, and judged.
  • Salience of drug cues is associated with striatal and frontal regions. As salience to cues decrease during and after treatment, functional connectivity between brain regions has been shown to change.
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At the end of Sally’s recovery journey, she achieves a sense of purpose and achievement. She starts to help others in familiar situations and maintains her own health as a peer support sponsor.
Explore Sally’s other paths to recovery
Click on one of the roads below to explore Sally’s journey
We’ll now explore Sally’s journey through Road 2.
Stage
Early Recovery
Sally grapples with guilt and depression after losing her job and relying on Medicaid. She endures intense withdrawal during detox and struggles with the tough experience of treatment. Starting a residential treatment program, she fears losing her family, pets, and work while balancing treatment with financial pressures.
1. MEDIAL PREFRONTAL CORTEX
  • Chronic exposure to stress and trauma during childhood led to neuronal loss in MPC
  • Impairs cognition and impulse control - predisposed to substance use
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Stage
Challenges and Setbacks
Sally adapts to her environment and forms connections at the treatment center. Although she initially wants to leave due to overconfidence, intervention from therapists and family encourages her to stay. She begins outpatient treatment but becomes anxious when a friend relapses, fearing she might leave treatment and struggle with a relapse herself.
1. PREFRONTAL CORTEX
  • Impaired top down regulation in PFC favors continued addictive behaviors
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Stage
Long-term Recovery
Sally forms a positive relationship with her sponsor and regularly attends group recovery meetings. Relieved to have a supportive network, she feels less lonely, isolated, or judged, and gains a sense of empowerment and hope. Despite the challenges, she remains determined to improve, working to change her environment and reconnecting with support groups.
  • Salience of drug cues is associated with striatal and frontal regions. As salience to cues decrease during and after treatment, functional connectivity between brain regions has been shown to change.
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At the end of Sally’s recovery journey, she achieves a sense of purpose and achievement. She starts to help others in familiar situations and maintains her own health as a peer support sponsor.
Explore Sally’s other paths to recovery
Click on one of the roads below to explore Sally’s journey
We’ll now explore Sally’s journey through Road 3.
Stage
Maintenance Stage
Sally begins Suboxone treatment and regularly meets with her primary care physician. As she tapers off by slowly decreasing her dosages, she faces challenges arguing with her commercial insurance provider about coverage.
1. MEDIAL PREFRONTAL CORTEX
  • Chronic exposure to stress and trauma during childhood led to neuronal loss in MPC
  • Impairs cognition and impulse control - predisposed to substance use
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Stage
Continued Progress
Sally stays at an upscale treatment center, consistently attending both group and individual therapy sessions. She begins trauma-based therapy, including EMDR, which helps her build resilience to negative memories. Although she feels relieved to have a support network, she struggles with boredom, lack of motivation, and anxiety about the future.
1. PREFRONTAL CORTEX
  • Impaired top down regulation in PFC favors continued addictive behaviors
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Stage
Long-term Recovery
Sally starts somatic therapy and takes on a part-time job. As her long-time therapist retires, she needs to find a new one. She continues working on herself, believing that, like physical trauma, psychological wounds can heal once the impact of disturbing events is addressed and emotional blocks are removed.
  • Salience of drug cues is associated with striatal and frontal regions. As salience to cues decrease during and after treatment, functional connectivity between brain regions has been shown to change.
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At the end of Sally’s recovery journey, she achieves a sense of purpose and achievement. She starts to help others in familiar situations and maintains her own health as a peer support sponsor.
Explore Sally’s other paths to recovery
Click on one of the roads below to explore Sally’s journey
This website was designed by Biomotivate team members including Shirley Du, Iris Liu, Mimi Chuang and Jessie Geng. It is based on a Biomotivate journey map diagram designed by Spoorthi Cherivirala which won 2nd place in the National Institute on Drug Abuse (NIDA) Mapping Patient Journeys in Drug Addiction Treatment Challenge.
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Stage 1 + 2 Road 1 Road 2 Road 3