It’s not always just about what is “allowed in US states” but making it easy for junkies who need a solution to be locally accessible vs just as easily going on the corner with $10 for another high. I was purposefully being colourful saying Suboxone was handed out like candy in Canada but it really needs to be to compete with the wide availability of Fentanyl.

Yeah this a key point. Buprenorphine availability is very inconsistent in practice throughout the US. I'm not just talking about rural Kansas here either, it can be a struggle in every state and many major metro areas. Especially if you have all the associated problems one might expect (no car, no money for a copay, other health problems, etc).

Additionally, the actual treatment provided varies considerably between doctors. Do they give the patient enough to avoid severe withdrawal? Do they allow the patient to stay on buprenorphine long term if needed? How do they handle relapses? What sort of counseling or therapy do they provide (if any)? Do they take insurance?

Buprenorphine is available through telemedicine (even before Covid).

https://www.statnews.com/2022/03/07/doctors-companies-push-t...

I wont argue there are some barrier, but it’s not hard to get anywhere in the US.

Your link says that it was not available by telemedicine before covid, and it may not be any more once covid rules end.

Can't see any way an official programme can compete on convenience with 24/7 street corner illegal supplies.

Seriously. The world would not end if you could buy Vyvanse and Targiniq over the counter. Just let people have the safest version of these substances and move on. Most aren’t seeking help.

I don't disagree. I just don't think it's practical to put a 24/7 pharmacy on every block.

Why do they need to be on every block? If there's no "it's a crime" markup, drugs are really cheap, and illegal supply chains can't really compete with Walgreens and CVS supply chains sending out semi-trucks full of product from distribution centers.

Don't just do one thing at once. Arrest and charge everyone related to drug trafficking at the same time as forcing every public user of hard drugs to report for testing when picking up their daily dose and enforce it with ankle bracelets.

Then because you're not just putting a bandaid on it you have the funds available to actually get people off the street (and not just into shitty drug hotels) which is one of the biggest obstacles to getting sober.

The change to allow anyone to prescribe it is very recent, prior to that it was extremely limited, and most providers will still not prescribe it for a variety of reasons, ranging from not understanding it to addiction stigma to fear of the DEA.

The sad fact is that most people who would benefit from it simply do not have access to it.