MARY LOUISE KELLY, HOST:
A bill headed to President Trump's desk could make it easier for people to get a drug to treat opioid addiction. Under current law, health care providers can prescribe only so much of it. The bill would ease some of those restrictions. For now, many people have turned to the black market to get the medicine and treat their addiction on their own. Jake Harper of Side Effects Public Media reports from Indiana.
JAKE HARPER, BYLINE: Anne and Daryl are about to do something illegal.
ANNE: It's the backside of that building that you see.
HARPER: Which is why NPR is using their middle names. They head to the back of a building in Austin, Ind., by some train tracks.
ANNE: The cars aren't going to drive. And if the police come check it out, they're - they could drive down here, but they're probably not. We're just going right here.
HARPER: They settle in. Daryl hasn't used in a while, and he's sick from withdrawal. So he preps two syringes. And he takes one of them, sticks the needle in his arm and pushes down the plunger.
What does it feel like?
DARYL: You feel 100 percent better soon as you do it.
HARPER: If you watch Daryl closely, he doesn't put heroin in the syringes. Daryl and Anne inject a drug meant to help treat opioid addiction, a medication called buprenorphine. Buprenorphine is a long-acting opioid, maybe better known under the brand name Suboxone. And for people who use heroin or other opioids, it reduces cravings and prevents withdrawal. Daryl says the first time he injected it, his nausea and diarrhea disappeared.
Did you feel high, or did you feel normal?
DARYL: I felt - at first, I felt like I was high. But I think it's where I've not felt normal in so long, I think that's what normal feels like now.
HARPER: But you're not supposed to inject buprenorphine. And Daryl and Anne don't have a prescription. Someone sold it to them illegally, which is known as diversion. Some state and national policymakers have pointed to this diversion as a reason to regulate buprenorphine prescribers more. But many addiction doctors say the problem is misunderstood. Dr. Kelly Clark is president of the American Society of Addiction Medicine. She says, for one thing, buprenorphine is not as dangerous as other opioids.
KELLY CLARK: We care about diversion from a public health standpoint because of the risks of overdose. And the risks of overdose with buprenorphine are minimal.
HARPER: You can overdose from buprenorphine, especially if you mix it with other substances. But it's rare. Buprenorphine is less potent than drugs like heroin and fentanyl and can even block their effects. This also means that few people use it to get high. Instead, more people use it to prevent withdrawal and to try to stay away from other illegal drugs. That's what Daryl and Anne did. Dr. Michelle Lofwall is an addiction specialist in Kentucky. She says people often try to treat themselves when they struggle to get into real treatment.
MICHELLE LOFWALL: These people want help. And they tried, and they didn't succeed. And so now they're going to go get it when it's available.
HARPER: It can be easier to get buprenorphine on the street. Prescribers can be hard to find, and federal rules limit the number of people they can treat. And patients need insurance or another way to pay for treatment. Lofwall says this street treatment is not ideal, but it can lead people to a big realization.
LOFWALL: I've seen that happen with people coming in wanting treatment specifically because they've had it, and they know it works for them. And they want to get it legally. And they want to get their life back.
HARPER: That happened to Daryl. The day I met him, he came into a clinic to sign up for insurance so he could get professional help.
Do you think trying it on the street the way that you have has led you to this?
DARYL: Yeah, I think so. I think where if I had never started them on the street, I wouldn't be sitting here right now talking to you because I would have no interest in doing nothing but getting high.
HARPER: He still hasn't made it into treatment. He had trouble starting his insurance. And when he couldn't find buprenorphine, he went back to heroin. Addiction can take years to conquer. But Daryl says his time on buprenorphine let him see a way back to a normal life. For NPR News, I'm Jake Harper.
KELLY: And that story's part of a reporting partnership with NPR, WFYI and Kaiser Health News.
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