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?