"They're really strict," she said. "It's because they want to help everybody."
Doctors diagnosed Stamper with scoliosis at age 6. They put titanium rods in her back at age 12. Afterward, they hooked her up to a morphine pump. She remembers lying there thinking it was the best she'd ever felt.
Doctors prescribed painkillers for Stamper on and off throughout her teens. She thinks she was physically dependent on them by 16.
At 18, she started abusing them, she said. She says she lived in an abusive household with her now ex-husband. Social workers took away their 1-year-old son.
One night, her friend brought over 45 Lortabs. They sat there and did them all. It was the first time she crushed and snorted a pill.
She could always find pills, she said over breakfast at McDonald's. She spots a few men at the cash register, in neon green shirts.
"I guarantee those miners have them," she said.
She used to send out mass text messages: "Hey, you got any painers?"
At one point, she used three fentanyl patches at a time. She stuck one on her head, another on her heart, and ate the gel from another. Fentanyl is 80 times stronger than morphine, and is prescribed for severe pain.
Took off like a rocket
Federal regulators approved Suboxone, manufactured by the drug maker Reckitt Benckiser, in 2002. Four years later, a federal law made it easier to get treatment.
In West Virginia, "it just took off like a rocket between 2007 and 2009," said Dr. James Becker, medical director for the state's Medicaid program. "Clinics were opening everywhere."
In 2006, West Virginia Medicaid paid about $360,000 for Suboxone claims. Last year, it was more than $4.7 million.
Today, 17 treatment programs and more than 90 private physicians in West Virginia offer the drug, according to the federal Substance Abuse and Mental Health Services Administration.
Unlike methadone, another drug used to treat opiate addicts, Suboxone doesn't have to be taken at a clinic. People can pick it up at a pharmacy just like any other medication.
Prestera developed its own support groups for people taking Suboxone because many traditional groups -- which are abstinence based -- do not believe in so-called Medication-Assisted Treatment.
Suboxone patients who attended traditional 12-step meetings "felt really unwelcome," Parker said. "And then they would have to try to get a sponsor and build a support system of people who don't trust them, who tell them they're not clean."
Although many recovery groups do not approve of Medication-Assisted Treatment, the medical community mostly does, said Dr. Louis Baxter, president of the American Society of Addiction Medicine.
Still, "We try to stress the point that medication is not used in lieu of the full treatment experience," he said -- detoxification, rehabilitation education and follow-up care, including ongoing counseling.
Addiction is like other chronic diseases, Baxter said. If someone has diabetes, their doctor should first encourage behavioral changes like a healthy diet. Some people need medication to stay healthy, he said.
When Suboxone came out, it was touted as a safer, better alternative to methadone. It contains Naloxone, a drug that hospitals use to treat people who have overdosed. If someone injects or snorts it, they'll feel unpleasant withdrawal symptoms.
Buprenorphine also has a "ceiling effect." Taking more of it doesn't increase its effects.
But people still sell it on the streets.
"Among drug addicts, it's seen as the miracle cure," Miller said, explaining that many addicts use the drug to bridge the gap between fixes.
A few years ago, Medicaid officials noticed something. Their data showed that West Virginians were routinely being prescribed 32 mg or more per day. The manufacturer's maximum recommended dose is 24 mg.
People were diverting the drug. Officials also discovered that some Medicaid patients were traveling out of state to get high doses of Suboxone -- paid for by West Virginia Medicaid. They were likely taking a few per day, and then selling the others, said Becker, the program's medical director.
Medicaid cracked down. Starting in August, only doctors enrolled in the Medicaid program could prescribe it to Medicaid patients. Patients now must have prior authorization. Medicaid also limited how much Suboxone it will cover per patient.
Medicaid endorses the use of Suboxone, when used with counseling and other support, Becker said.
"We just see it as a pathway to where [addicts] can recover their lives," Becker said. "Medication's not the ultimate answer."
Stamper says she looks forward to the day she won't need medication. Her main motivation is her son, now 7, and nearly 1-year-old daughter. Both live with family members because of her drug problem.
"I just want to be free of any type of drugs, have my family in my life, and make something of myself," she said. "I wasted a lot of time, and it's hard to fix it all at once."
To learn more about Prestera's program, call Josh Parker at 1-800-642-3434.
Reach Alison Knezevich at alis...@wvgazette.com or 304-348-1240.
This series was conceived and produced as a project for The California Endowment Health Journalism Fellowships, a program of the USC Annenberg School for Communication & Journalism.