March 6, 2023 – “I don’t want my patients to die from an overdose,” Win says. “But I’m not comfortable with the fentanyl and a lot of narcotics in the system.”

Kim is adamant that she’s not intentionally ingesting fentanyl. It might have been in the cocaine she says her roommate shares occasionally. Kim says she takes the Xanax to sleep. Her drug use presents complications that many primary care doctors don’t have experience managing. Some clinicians are apprehensive about using an opioid to treat an addiction to opioids, despite compelling evidence that it saves patients’ lives.

Win is worried about writing her first prescription for Suboxone. But she agrees to help Kim stay on the medication.

“I wanted to start with someone a little bit easier,” Win says. “It’s hard for me, that’s the reality and truth.”

About half of the providers at the health center had an X-waiver when it was still required. Simmons says some of the resistance to having the waiver was rooted in stigma or misunderstanding about addiction. She urges doctors to treat addiction as they would any other disease.