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Southwest Virginia patients struggle with access to addiction medication

Earlier this year, the federally qualified health center announced it was expanding services to...
Earlier this year, the federally qualified health center announced it was expanding services to Tazewell, which — like much of Virginia’s southwestern corner — had been hit hard by the opioid crisis.((Source: Pixabay))
Published: Apr. 11, 2022 at 9:11 AM EDT
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Marcy Rosenbaum had a problem.

For years, Southwest Virginia Community Health Systems had been running successful recovery programs from its clinics in Bristol and Saltville, small communities encircled by the Appalachian Mountains. Earlier this year, the federally qualified health center announced it was expanding services to Tazewell, which — like much of Virginia’s southwestern corner — had been hit hard by the opioid crisis.

The system offers what’s known as office-based addiction treatment, commonly abbreviated as OBAT. Services include psychotherapy and counseling along with medication, a crucial tool that can relieve cravings and help prevent withdrawal symptoms.

But as Rosenbaum, the system’s behavioral health director, was starting the new program, she stumbled into a huge barrier. Not a single pharmacy in Tazewell or the surrounding community was willing to prescribe Suboxone, a drug used to treat opioid addiction that’s also known by its generic name, buprenorphine. Ashley Harrell, a senior program adviser for Virginia’s Department of Medical Assistance Services, said two different OBAT providers in the region reached out to 38 pharmacies — 18 chains and 20 independent stores — and everyone refused to dispense the medication.

It’s created an access problem that state and federal agencies have struggled to resolve. Southwest Virginia has some of the greatest need for recovery services, according to Rosenbaum. But the lack of willing providers has limited the reach and scope of existing programs.

“We’re not advertising at all because we’re afraid we’re going to get people in and not be able to get them the medication they need,” she said. “Tazewell County has one of the highest overdose rates in Virginia, so it’s frustrating not to be able to expand those services.”

Experts say the issue is multifaceted, putting an easy solution out of reach. And in many ways, the roots of the problem stem to decisions made at the federal level. Steve Hylton, an independent pharmacist in Saltville, said the U.S. Drug Enforcement Administration has come down hard against buprenorphine despite publicly supporting medication-assisted treatment. He pointed to a pharmacy in West Virginia that was raided by the agency after providing the medication to customers.

Though two judges later ruled in favor of pharmacist Martin Njoku, according to reporting from NPR, the DEA’s actions effectively shuttered the business. In court transcripts from the case, an assistant U.S. attorney said the agency’s aggressive stance stemmed from criticism over its lack of action during the height of the opioid crisis.

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.(Virginia Mercury)

The Virginia Mercury is a new, nonpartisan, nonprofit news organization covering Virginia government and policy.

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