Imagine a patient named Rosa tells you she wakes up night after night in a drenching sweat after having very realistic dreams of smoking fentanyl.

The dreams seem crazy to her. Three months ago, newly pregnant, Rosa began visualizing being a good parent. She realized it was finally time to give up her self-destructive use of street fentanyl. With tremendous effort, she started treatment with buprenorphine^[1] for her opioid...