Several months ago I posted an item asking for readers to give me the scoop on suboxone, a relatively new drug that is used to treat opioid dependence. A lot of people get to this blog because they Google the word suboxone, but I was not aware of any legal controversy around the drug. I asked for feedback and got plenty of it, and I had meant to write a follow-up item earlier. After talking with a lot of people, the consensus seems to be that suboxone is a really helpful drug for a lot of people who have struggled with opioid problems, and seems to be easier (at least for some people) to get off of than the more “maintenance”-oriented methadone (but see a couple of the comments in the post linked to above, which suggest otherwise). One issue that people mention over and over, though, is the difficulty of actually obtaining suboxone. Some people refer to the difficulty of finding a doctor who is certified to prescribe it. Others talk in particular about the challenge of paying for it, either because they have no insurance and can’t deal with the cost or because their insurance will not cover it. As one reader put it: “My biggest problem or objection about the Suboxone system is that this fantastic medication that really works is exclusively targeted at those with means rather than to the vast bulk of opiate abusers who can’t afford a pot to piss in.” I don’t know that there is any obvious solution to these issues, which seem to be inherent in a system that combines heavy government regulation of scheduled drugs with a for-profit medical/pharmaceutical industry. I talked with a reader on the phone about this for a while the other morning, and ended up saying “the answer is, there is no answer.” Which is a rough conclusion, and I would be happy to learn that there actually are options for people who need access to effective treatment.