By Melba Newsome, Health Affairs, January 2021
By all accounts, it looked like twenty-eight-year-old Amelia Carmelo had turned her life around by the end of 2018. After more than a decade of heroin and opioid addiction, she had been free from illicit drugs for more than four years and was in a stable relationship. For the past year she’d driven thirty minutes each week to see her addiction counselor.
Carmelo began her nascent recovery in early 2015 after spending several months in jail. She managed to string together a few weeks of recovery by sheer force of will but knew from experience that she could only white-knuckle it for so long before she relapsed.
She found a doctor in Polk County, North Carolina, who prescribed Suboxone, a combination of buprenorphine and naloxone used to curb the opioid craving. But after a few months the doctor’s practice was shut down by authorities for violating prescribing guidelines. Unable to find another local physician authorized to prescribe the drug, Carmelo felt she had to make a choice: relapse or find another way to score Suboxone. She resorted to paying hundreds of dollars a week to illicit dealers or anyone willing to sell it to her.
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