Web Dateline: CHARLESTON, W.Va. --
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The young woman slips the orange tablet into her mouth, chin jutting out as she presses it under her tongue.
Ashley Stamper takes the pill twice a day, morning and night. In 10 to 15 minutes, the little hexagon will dissolve. She won't feel quite right until it kicks in.
Suboxone seeps into her system. Doctors prescribe it to help ease the cravings and kill withdrawal symptoms of opiate addicts who are hooked on painkillers like OxyContin, as well as heroin.
Alcohol remains the main reason people check into rehab, but West Virginians' demand for opiate addiction treatment has skyrocketed.
In 1999, about 5 percent of West Virginians seeking treatment needed help for opiate addiction, according to federal figures. Last year, that proportion was more than 26 percent.
Many are turning to Suboxone, the brand name for a medication whose primary ingredient is the drug buprenorphine.
Experts say the medication must be combined with counseling and other support to really help. Some users are selling it on the streets, which led the state to tighten controls on the drug.
Some people will say Stamper, 25, is just trading one addiction for another. In the past, though, the pull of OxyContin, fentanyl, Lortab and other painkillers was so strong she didn't care whether she lived or died.
"I'm not out there using and searching and partying," Stamper said.
Not just 'a handful of pills'
Stamper started going to the Prestera Addiction Recovery Center in Dunbar in August. On a frosty November morning, she waited with other customers at the CVS pharmacy a few blocks away from the center.
It wasn't yet 8:30 a.m. The six seats in the waiting area were filled. More customers lingered in the vitamin and nail care aisles. By the time they all left, they carried white paper bags with bottles of Suboxone inside.
In 2008, Prestera -- the state's largest mental health provider -- and three other providers got a $360,000 grant from the Robert Wood Johnson Foundation to increase access to Suboxone.
Prestera's program now has five doctors and more than 260 patients.
"We're not giving people a handful of pills and a kick in the butt," said Josh Parker, director of Prestera's Suboxone program. "They actually have to get treatment."
Stamper and others in the program attend mandatory one-on-one and group therapy, plus four 12-step meetings weekly.
"I'll be the first to tell you, there is no magic pill for addiction," Parker said. "Trying to battle addiction takes a lot of hard work, a lot of life changes, and a lot of support. And that's what we try to help them develop."
Doctors taper doses to wean patients off Suboxone. Some people get off it in six months, Parker said. Others take nearly two years.
Addicts get "dope sickness" when they quit using opiates. Withdrawal causes diarrhea, muscle cramps, fever, chills, depression.
"You feel like you're dying," said Kim Miller, manager of Women's Addiction Services for Prestera.
The physical symptoms aren't the only hard part of beating an addiction. Many women addicted to painkillers suffered sexual abuse and other trauma, Miller said. That's why therapy and other support are so important.
Stamper says she's "all about staying sober." She enjoys going to therapy, getting things off her chest. She likes listening to other addicts tell their stories at 12-step meetings.
Some people sign up just to get the pills.
"They usually weed themselves out real quickly," Parker said.
Pill counts and drug tests help ensure clients aren't selling their Suboxone or abusing other substances.
Not all opiate addicts need medication, he said.
"Prestera has tried to use it pretty much as your last chance of getting clean," he said.
Stamper tried methadone treatment before. She couldn't function on it. Cigarette burns cover her arms -- she used to "nod out" on methadone.
A few weeks before Christmas, Stamper waited with about 20 other Prestera clients in a bare room at the mental health center. At the front of the room, a doctor and nurse sat at a folding table with a stack of files. They called them by name to write their prescriptions.
The crowd had thinned out since the last time Stamper had picked up her prescription two weeks earlier, she said. A lot of people had been kicked out of the program.