Only 13 percent of Americans receive treatment for substance abuse disorder. The reasons for this alarming gap are, like the causes of addiction itself, multifarious. In West Virginia, the state hardest-hit by the opioid epidemic—where the number of deaths outpaces births—four people who struggled with long-term addiction underwent an experimental procedure in which a microchip was implanted to deliver electrical shocks to the part of the brain involved with processing desire, motivation, and reinforcement. For the September issue, Zachary Siegel, himself a recovered opioid addict, spoke with two participants from the surgical trial. In this episode, Siegel and host Violet Lucca discuss the shortcomings of abstinence-only treatment, received wisdom about sobriety and relapse, issues raised by deep-brain stimulation, the lack of urgency around the opioid crisis, and much more.