The day each of us received our licenses from the Drug Enforcement Administration, we were able to write prescriptions for oxycodone and fentanyl, two drugs that have fueled the opioid overdose epidemic. But we couldn’t prescribe buprenorphine, a far safer partial opioid that is an effective treatment for opioid use disorder, without getting additional training, a special license with a number that begins with “X,” and agreeing to allow DEA agents to inspect our patient records.

That doesn’t make sense to us, especially as our country is in the midst of an overdose epidemic.

Opioid use disorder can cause tremendous suffering for people with it and their families. As physicians who specialize in addiction medicine, we have seen the transformative effects of treatment with medications such as buprenorphine. When combined with naloxone, it’s sold as Suboxone. People who take it report that they no longer feel compelled to use illicit opioids. They can focus on their recovery and on restoring their relationships.

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Yet in spite of the fact that buprenorphine has been available as an effective treatment for opioid use disorder for 17 years, opioid overdose deaths are now the number one cause of accidental death in the U.S. Nearly 50,000 people in the U.S. died from opioid overdoses in 2017, the last year for which there are complete statistics. That’s equivalent to the number of Americans who died in combat during the Vietnam War. Since 1999, nearly a half-million Americans have succumbed to opioid overdoses.

As we and a colleague argued in a Viewpoint in JAMA Psychiatry, one possible solution to this terrible epidemic is hidden in plain sight: remove governmental restrictions on prescribing buprenorphine to treat addiction.

Before the turn of the 21st century, the only way people suffering from opioid use disorder could get effective medical treatment was through tightly regulated opioid treatment programs that administered methadone. Methadone is an extremely effective treatment and the structure of supervised dosing can be helpful for some patients. Yet the requirement to attend a clinic every day and wait in dosing lines, along with the stigma associated with receiving addiction care outside of the traditional medical system, prevented many from getting this lifesaving treatment. People want the option to receive care for opioid use disorder in the same place and by the same trusted providers who manage their diabetes, depression, or hypertension.

When Congress passed the Drug Addiction Treatment Act of 2000, it opened the door to allow the secretary of Health and Human Services to give waivers to qualified clinicians — physicians, nurse practitioners, and physician assistants — that allowed them to treat opioid addiction in settings other than traditional methadone clinics. Buprenorphine, which was approved for treating opioid use disorder in 2002, made office-based treatment even easier.

Clinicians who qualify for this waiver receive DEA licenses that begin with the letter “X.”

Many experts hoped that most clinicians would apply for the wavier and begin treating opioid use disorder like they treat any other health problem. Sadly, that never happened. Under 7 percent of U.S. physicians currently have DEA waivers. Even among newly trained doctors, few complete the necessary steps to get this license. As a result, more than half of the counties in the U.S. lack even one buprenorphine prescriber.

There are several reasons why so few doctors and other prescribers get the waiver. Lack of training in how to diagnose and effectively treat opioid use disorder is one hurdle. Obtaining the waiver requires extra training (eight hours for physicians and 24 hours for nurse practitioners and physician assistants) and then submitting an application for a waiver license. Agreeing to inspections of office records by DEA agents is a deterrent, as physicians fear this kind of scrutiny. Then there are practical matters, like finding colleagues who also have the waiver who can cover a practice, that discourage doctors who obtained the waiver from ever actually using it.

Stigma is another barrier, from both the physician and patient perspectives.

The media has long demonized people living with opioid use disorder. Even clinicians use stigmatizing language like “addict” or “drug abuser” or refer to recovery as “getting clean” or call a urine drug test that shows evidence of ongoing opioid use “dirty urine.” This is language that would be unacceptable for any other medical condition. Imagine a physician telling a patient with high cholesterol and obesity that she is a food abuser and her blood was dirty with cholesterol.

Misunderstandings about the role of medication in treating opioid use disorder also continue to influence treatment decisions. Despite decades of research showing how effective buprenorphine is at increasing remission rates and preventing overdose deaths, the myth persists that people who take buprenorphine are simply replacing one drug with another and are still “addicted.”

Some doctors worry, needlessly, that people with opioid use disorder will be unusually difficult patients. Others worry about the impact of addiction treatment on their other patients.

Stigma is also a barrier to patients. Our patients often tell us they feel stigmatized by doctors, nurses, pharmacists, and even friends and family. Outside of cost, stigma is the single largest barrier to opioid treatment. “X” waivers perpetuate this stigma and marginalize patients, making them feel less worthy. Patients often experience barriers trying to fill prescriptions for buprenorphine — told they cannot fill it if the “X” is missing from the prescriber’s license number — or feel shamed when filling buprenorphine prescriptions. Some feel embarrassed telling other doctors they are taking buprenorphine.

Deregulation of buprenorphine could help in three main ways.

First, deregulation would eliminate the extra steps needed for clinicians to prescribe this medication. It would likely encourage training programs to ensure that clinicians were better prepared to prescribe it.

Second, it would reduce barriers that patients face in finding prescribers, since any clinician with a DEA license could prescribe buprenorphine. Deregulation would help normalize prescribing and ensure that clinicians working in emergency departments or hospitals could prescribe it.

Third, and probably most important, deregulation would help remove the stigma from treatment. Taking the “X” off prescribers’ licenses would send a powerful signal to the medical community and patients that opioid use disorder is no different than diabetes or other chronic health problems.

Would deregulation work? After France instituted this approach in 1995, deaths from opioid overdoses dropped nearly 80 percent. A similar drop in the U.S. would mean 37,000 fewer deaths from opioid overdoses in 2017. It’s true that the U.S. is not France. All French citizens have health insurance and Americans with insurance pay much more out of pocket. But even if deregulation of buprenorphine prescribing led to “just” a 50 percent decrease, that would mean 20,000 fewer deaths.

Skeptics worry that some patients will sell their buprenorphine, much like some sell their oxycodone. That could happen. The current shortage of prescribers creates a black market for the illicit sale of buprenorphine. But if buprenorphine were more widely prescribed, the black market might begin to dry up and fewer people would try to sell it. Although there is limited research about the illicit use of buprenorphine, several studies suggest that the main reasons people buy illicit buprenorphine are to self-manage withdrawal from opioids or to self-treat their opioid use disorder. If that’s the case, greater access to buprenorphine via legitimate channels would be a positive intervention.

Within the medical and behavioral health communities, some practitioners worry that increasing access to buprenorphine without requiring participation in counseling will not be effective. However, studies comparing adding psychological interventions like cognitive behavioral therapy to buprenorphine therapy with medication management alone (meaning counseling from the prescriber during the visit, much like primary care providers do for other health conditions where treatment involves behavior change, such as diabetes, high blood pressure, or obesity) have found these two approaches to be equivalent.

To be clear, this does not mean that psychological care and substance use counseling aren’t important. Behavioral therapies should be readily available to patients with opioid use disorder and integrated whenever possible into their care. But given the clear evidence that medication management with buprenorphine in primary care settings is effective with or without adjunctive counseling, deregulation of buprenorphine is an important step to expand access.

What about safety? Buprenorphine has a much better safety record than opioids like oxycodone or fentanyl that are commonly prescribed for pain. Between 2002 and 2013, 464 deaths in the U.S. were attributed to buprenorphine, or one-thousandth the number of deaths attributable to opioids during that period. Most buprenorphine-related deaths occur when the drug is mixed with alcohol or sedatives.

We strongly believe that deregulating buprenorphine and making it easier for clinicians to prescribe this medication will on balance save many lives. We also believe that Congress should take additional steps, such as requiring basic training in how to appropriately prescribe buprenorphine for opioid use disorder and providing incentives for doctors and other prescribers to prescribe buprenorphine for opioid use disorder and to encourage individuals with opioid use disorder to seek counseling for it.

We are puzzled why Congress has yet to take these simple steps to help end the opioid overdose epidemic.

Kevin Fiscella, M.D., is professor of family medicine, public health sciences, and community health at the University of Rochester and co-director of its Center for Communication and Disparities Research. Sarah E. Wakeman, M.D., is the medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School.

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  • I wholeheartedly agree with both the authors above. We have to stop the stigma surrounding MAT for OUD and get patients into treatment. This is a terrible epidemic and so many people are dying needlessly. My feeling is that unfortunately many docs will not get on board even without the X number. Most docs do not understand addiction and feel the patient should just suffer through the withdrawal. Clearly this strategy is not working as the number of deaths is still the same, if not higher, than the year before. All we can do is keep touting the benefits of MAT and get as many people into treatment as we can! I have been a Suboxone provider since 2002 and it is the most rewarding thing I have done as a physician. When you see the patient even as soon as 2 weeks later, they look and feel better than they have in years!

    • Thank you Lisa for your input. I wish (hope) you practice in / near the Phoenix Valley, cause I would drive hours to enjoy a relationship with a Provider that truly cars and understands.
      As my previous post states, after 8+ years of “pain management”, I had a moment of clarity (or desperation) one day about 8 years into “pain management” which consisted of monthly visits, 2 – 3 hours waiting in sometimes a standing room only waiting room (I have a ruptured disc and 4 herniated discs) only to get a prescription for more narcotics that I never, ever ask for, or to schedule another “treatment” of spinal injections that were all worthless (at least a dozen “treatments”, epidural injections once every week x 3 weeks). At that moment of clarity, I realized I was taking over 800mgs of Morphine, extended release morphine and Oxycodone daily, stopped working on the pain years before and only kept the withdrawal symptoms away for maybe 2.5 – 3 hours.
      My Suboxone experience with the drug itself has been wonderful, stability has returned to my life although I haven’t had a pain free day in over a decade and never expect to. I average between a 2 to a 4 on the pain scale 24/7. I should also state that I have been taking Lyrica for almost as long as I’ve been taking the Suboxine. Really helps with my nerve pains and helps some with my spinal pain.
      I have self detoxed myself from the 24 mgs a day the Suboxone provider (nothing less than a methadone clinic type of place, so I’ve been told, but they don’t prescribe methadone) raised me to soon after being released from detox. I’m now down to 8 mgs a day (4 mgs morning, 4 mgs late afternoon) but I don’t seem to get any lower.
      I’ve recently heard of Belbuca, do you have any experience with Belbuca or any other suggestions for me ?
      I’m tired of being a “slave” to any prescription drug, and hate worse the way I seem to be treated like a street junkie. I’m a 60 year old successful business owner (prior to my back injury), never been a drug addict and never imagined my “golden years” filled with constant pain and treated like a junkie.
      Any feedback or suggestions would be gratefully appreciated.
      Make it a great day.

  • Suboxone “clinics” have turned into what many fellow patients have described to me as nothing more than Methadone Clinics.
    The place I was referred to after 7 day hospital detox from 8+ years of “pain management” scam (which had me on over 800mgs of Morphine & Oxycodone daily) immediately told me the 8mgs of Suboxone I was discharged from the detox on “was nowhere enough”, so the Doctor upped me to 16mgs daily. After less than 6 months I explained (to the 3rd new PA since I’ve been there) that my spinal pain was at times unbearable. She upped me to 24mgs daily.
    2 months later, new “rules”. Now I was required to show up weekly ($85 cash deductible + a 3 hour drive). Waiting room was almost always standing room only. Many other patients were heard constantly saying “this place is as bad as a methadone clinic”.
    So I’m trying to find a real doctor, not a “clinic / methadone outfit” that will let me make the appointment once per month and help my get off of this Suboxone. Any suggestions or links to related forum(s) would be greatly appreciated. I live just north of Surprise, Arizona.
    Thanks in advance.

    • How did you find your Subox doc? I had to go to an all cash charlatan, do my ‘induction’ at home, and then, miracle of miracles, my health care provider, who has his certification, felt confident that I was doing well, and it would be safe for him to add me to his tiny list of Suboxone patients.

      I have terrible back problems, have had at least 10 injections, 3 rounds of physical therapy, pilates, diets for anti-inflammatory….I was on high dose ms contin w/percocet and I switched to Suboxone to escape side effects, but not live a life with such intense pain.

      Started at 24 mg. the company literature (Indivior) says some people need 32 mg. It would make sense that someone on high dose opiates would need hi dose Suboxone, at least for a while.
      I don’t know if you know this, but The company that makes Suboxone is undergoing legal challenges, there are going to be other products on the market that are comparable, there might be another way to find an ethical treatment provider thru a company referral service.

  • As a counterpoint, physicians with unfettered access to opioids are a major contributor to the opioid crisis in this country. The X licensing involves 40 hours of continuing education and training so that providers learn to prescribe these medications properly.

    Physicians who are overworked and disinclined to deal with problem patients are more likely to write a prescription for Oxycontin or Hysingla than actually deal with a patient’s problem, and just because someone has a MD or DO after their name, it does not necessarily make them qualified to deal with pain management or detox.

  • I have been on suboxone 8.2mg films since 2007.I was not an opioid abuser I have fibromyalgia and live in constant pain.My pain management doctor informed me that the Pill Mills were being shut down and that I would have to switch from Vicodin to suboxone even though I was not abusing my pain meds.I was taking the same amount of Vicodin that I had been taking for 4 years.My dosage was working for fine for me.My private health insurance did not cover the visit or the script how ever I could afford to pay out of pocket.My dosage worked for me,I was able to work and support myself and my 2 kids.However at the urging of my doctor of 5 years I went ahead and switched to over to suboxone.Well his office only stayed open for 9 months.So in the last 10 years I have been thru Hell..I have seen at least 7 different Sub doctors..Each one has different rules,they charge anywhere from 120$-225$for a visit.Most prefer cash,most want to see you every from 3 to 4 weeks and then do a drug test that they charge you for.None of them accept insurance.The other thing with suboxone and subutext is that it is an affective pain reliever.So once you get your dosage regulated it helps tremendously with your chronic pain but of course private insurance will not cover it…My son who has been on disability since he was 20 is also on subutext(he could not tolerate the naloxen)has had to spend 450$a month of the 770$that he gets on the script.There is something Very Wrong With This Picture.!!!Also as soon as we get settled with a Doctor something will happen and we will end up having to find A New One..So like this Doctor is saying this whole process needs to be made easier.My son and I are not druggies trying to score,We are regular people trying to live with Chronic Pain within the confines of a society that has deemed any one that lives With True Chronic is Now Drug Abuser.I challange you to live in my son’s in body-he has all 3 forms of arthritis psoaritiac,rheumatoid and osteoarthritis.He is 35 and his bones are 65 years old.He has had all teeth pulled due to rampant decay from the meds he has taken.He is 5’6″ and weighs 90lbs and now is 85% covered in psoarsis.He suffers from clinical depression all this because he can’t get proper pain management…So Thank You All You Do Gooders Out There Who Managed To Shut Down All The Pain Doctors …You Know Not Every Person Was A Frickin Drug Addict.You Should All Have To Spend An Hour In My Son’s Body..And If That Doesn’t Convince You Then Spend An Hour In Mine..

  • Subutex is also an effective – and safe – painkiller. Unfortunately, providers are capitalizing on the shortage by making patients show up for office visits & urine tests every 28 days. It’s far less of a burden to have your PCP prescribe Schedule II painkillers.

    • Subutex is much better for pain but these” know it all” acts like it’s the devil! We all aren’t abusers of the drug. I’m bout to go crazy if I can’t try sutuex which I have with Celebrex and it’s was a miracle. When I take Suboxone I feel like I’m gonna have to have knee replacements! Why do these Docyors think Subutex isn’t gonna help and all seem to have their hands tied! So mad! I’m looking at surgery or pain pills ugh ugh

  • I drive an hour to get to a doctor that can prescribe suboxone. Due to insurance, Im now on Zubsolv. It has saved my life. I never used heroine but took upwards of 40 vic a day. Ive been clean for 11 years!

    • Congratulations Kristy and thank you for sharing this info. It is the people in recovery who are the most effective in getting others into recovery!!

  • This is one of the most rational and humane policy proposals I’ve seen in connection with the opioid overdose pandemic.

    I have this question about suboxone and its variants: I have heard about users using very small doses – say 1-2 mg – of suboxone daily, which is enough to effectively relieve withdrawal and opioid cravings. A single, diverted 8mg/2mg strip can last for a few days used in this fashion, whereas the recommended dosage range for prescribed suboxone goes up to 24mg/day. Why this discrepancy, and is it not a likely contributing cause of diversion?

    • I had a huge addiction to pain pills, when I went to rehab/detox I needed 26mg/day. I still had severe withdrawal symptoms so they tried giving me the full 26mg/day in the morning. It worked! Its been 11 years. But Im now down to 5 mg/day (zubsolv). The problem is cutting the 8mg/2mg strip, the pharmacy & makers dont recommend it. It can lose its effectiveness. Better to take the 2mg strip, 1x a day. But that cost more $! Luckily insurance is starting to pay for these drugs. I used to jump through hoops with “preauthorizations.” Anyway, it would be great if any Dr could prescribe these. Some hospitals cannot give suboxone bc no dr can prescribe it! Addicts are treated with opioids and sedatives. Its sickening to watch. I have to drive an hour to the nearest Dr….Imagine if I lived in a more rural area..sad

  • Also don’t do buphernorphine trial unless you have been genetically tested and they know it’s going to work for you. Otherwise you go off opoids you’ll never be able to get them back. The cost of $300.00 is well worth the price on weather or not it works for yourself. BE CAREFUL for the price could be hell for you.

  • How does one get help after they get off opoids for the so called new medication. I never had issues or abused it . Now doctor talks about buphernorphine being the latest greatest would you try it, I did and it was the worst thing I could have done. Doctor lied to me and never told me that if I do trial and it doesn’t work that he wouldn’t put me back on what I was taken, Now 1 1/2yrs later I’m getting nothing for pain. You could ask anyone that knows me that I should of been told this option to better let me make a decision, on whether or knot to try buphernorphine. I was walking almost 3 miles a day, cooking, weeding gardens, and taught myself how to sew eventually quilting. Basically living a more normal life. Now can’t get out of house without killing my self. I would of had Mayo take foot off and hope for best. Thirty years dealing with a issue a doctor did trying to make the best of things. Since buphernorphine didn’t work have more doctors bring up smoking pot because they won’t do piss test. I had genetic testing which shows buphernorphine doesn’t metabolize in my body. Maybe genetic testing should of been done first. Now being told to self medicate for they don’t pea test. Now if pot would of worked boom don’t need doctor. Problem is that it doesn’t work for me, so now what do I do. Suffer, well this is no way to live. I’m actually thinking about what friends have said and go to the TV. But my issue is I don’t want sympathy just want help, WANT What Life I DID Have AS OPPOSED To NO Life. I just want a piece of what I had. To think my doctor told me to go to a mental hospital but don’t tell them I sent you. I was so desperate I went. What do they say were mental not physical. If anyone can give me a answer PLEASE DO. I have always been a fighter but that fight is about over after 1 1/2 years with no help.

    • Buprenorphine isn’t supposed to be used as a pain drug. It doesn’t work. It’s the partial agonist thing – bupe covers the withdrawal symptoms, and that’s about it. No euphoria, no pain relief, hard to od. How common is your genetic issue? Can’t you explain your predicament to a new pain specialist, just like you did above?

    • Buprenorphine is absolutely used as a pain medicine and it works very well for some people. It was actually approved for pain in 1981, 20 years before it was approved for use in addiction. Veterinarians also use it as a pain medicine for animals, and we know animals aren’t playing the kinds of games with opioids that humans tend to play (“I have an allergy to codeine,” “My pain is at a 10,” etc.) So while I don’t like to be contrary, the other reply seems to be misleading you. It’s possible Suboxone doesn’t help you with your specific pain, but some people derive real benefit from it. My neighbor is a Vietnam Vet with painful injuries he’s dealt with for years. He was able to get a very small amount of Suboxone to take (2 mg, I believe) and he said it was the only thing that had ever actually taken his pain away, plus it lasted a lot longer than his usual Vicodin.

      After Oct 6, 2014, pain pills like Vicodin were changed from Schedule III to Schedule II drugs, making it much more difficult to get a prescription and requiring a monthly written prescription for it (no pharmacy call-ins allowed), so it’s no longer practical for use in treating chronic pain. Doctors are also watched much more closely if they prescribe it. You’ll have a difficult time finding a doctor to prescribe one of those drugs, which is awful for people with chronic pain, but I guess they felt it was necessary with 50,000 people dying from opioid overdoses each year and most of those addictions started because a doctor gave the patient hydrocodone for pain.

      I don’t know if you’ve tried this, but I read that buprenorphine used for pain should be taken in very small doses, no more than 2mg. If you’re taking the usual 8mg or more, that may be why it’s not working well. Buprenorphine has a really strange way of working in the brain, so less can be more in some cases, depending on what you’re treating. The Butrans transdermal patch is a low-dose buprenorphine med that’s recommended for pain. It might be something for you to try, but it’s important that your doctor have a good understanding of buprenorphine. It’s a complex drug that most doctors have never heard of. Using it for pain and using it for addiction are two very different things.

      I hope you and your son are able to find a way to get relief from your pain. Best wishes.

    • I can also confirm that Suboxone works very well for certain types of pain. I have had 2 surgeries, once for a ruptured disc and then 3 years later for a herniated disc.

      If I had to do it over I might not have gone through the 2nd surgery but at the time my step son had just been diagnosed with an aggressive cancer and did not want to try to deal with pain during that ordeal (sadly took his life 3 years later). Since I didn’t have the luxury of predicting and after what I went through during that 3 years, maybe it was the right decision.

      I started off at the pain clinic following the 2nd surgery because of severe around the clock pain. It was like my neck and shoulders were in a constant state of being overworked and the ache & pain never let up no matter how much stretching, ice, heat, medicine, etc… After trying to manage going back and forth between tramadol and oxycodone, I got sick and tired of taking medicine that worked 1-2 hours at best and being limited to only 2 pills each per day.

      After hearing an ad on TV where a clinic was specifically advertising Suboxone for pain management. I made an appointment and over time managed to find a doctor that does not require me to visit monthly. It does not control my pain 100%, in fact, nothing EVER did that. (Nor do I expect anything ever will).

      In all this time (6 years since), I have never once had to adjust my dosage. I take the same dosage every single day and the pain is at a manageable level.

      I am so grateful it is available, but with the renewed focus on “addiction” I worry that good ole Uncle Sam will once again allow regulations that have the opposite effect by harming the good people while doing nothing to curb the destructive habits of the bad apples. Can’t I just live a normal life, I’m sick and tired of worry and fear over things I have zero control or influence to affect!

      I plan on asking my doctor to see if he can move me to Belbuc which is a somewhat newly approved version specifically for chronic pain. Hopefully with my excellent prescribing history (never a single “dirty” drug screen) I stand a chance to finally drop the stigma I’ve had to adopt just to have some normalcy in my life.

      Yes, things really do need to change. Not everyone is a drug addict. In fact, the vast majority are not. I wish we could stop reacting to bad apples and find ways to meet in the middle for responsible people!

  • I don’t abuse my opiads but I hate to think what would happen to me if you took my oxycodone away from me. I won’t do the physical stuff to ease my pain , so what alternative do I have. We need a new safer drug for pain. Opiads seem to work just fine for me. It also appears that death from buprenorphine accurs at a much higher rate than oxycodone.we need another drug for pain.

    • Yes there is for they weren’t told that if you go off opoids then you’ll never get back on them. Make sure that buphernorphine will work for you.

    • Just don’t let them take you off. I have done everything including the physical which I was doing long before I got off opioids. Exercised everyday and now you wouldn’t even know I was that same person. now I really just want to get outside and can’t.

    • “Tennessee Dept of Health found a total of 67 deaths *associated with* buprenorphine in 2016. Most people had taken multiple drugs prior to death.”

      In Tennessee, 1009 people died from Natural and Semisynthetic Opioids (e.g. oxycodone, hydrocodone) in 2016.

      In the U.S., 14,487 people died from Natural and Semisynthetic Opioids (e.g. oxycodone, hydrocodone) in 2016.

      (I don’t have the country-wide number for buprenorphine-associated deaths.)

      Many, many more people overdose on typical pain pills than they do on buprenorphine, and the people who are thought to have overdosed on buprenorphine had usually taken many other drugs along with it, but since bupe was in their blood, it was recorded as a bupe-“associated” overdose.

      Buprenorphine is probably the safest opioid in existence, so don’t fool yourself or others by claiming oxycodone is somehow safer. Oxycodone is more likely to kill you by overdose or by the acetaminophen destroying your liver and you’re far likelier to develop a dangerous addiction to oxy.

      Oxy is a beautiful drug, for sure. If I could feel that high all day, every day, I would. Taking oxycodone for three months after my back surgery at age 19 was how I was introduced to the heavenly feeling of opioids. I took them as prescribed for the first couple months, then one day (because I was a druggie at heart) it occurred to me that taking two might be nice, so I took two, and few things have ever felt that wonderful to me in my lifetime. I didn’t become addicted to pain pills at that time, but a few years later I sought them out for recreational use and ended up taking 20 hydrocodone a day for three years until I discovered Suboxone in 2004. So now I’ve been on Suboxone for 15 years. The end. 🙂

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