DOCTORS WHO TREAT people with opioid addiction have led the charge in Washington to expand access to the medication buprenorphine because they’ve seen over and over how it can turn lives around.

“For those who end up using it, it is a lifesaver,” says Dr. Lucinda Grande, who first talked to me about bupe for a story in 2014. “Most of them probably wouldn’t be alive if they weren’t on that medication.”

Easier access to a better treatment — buprenorphine — is helping people with opioid use disorder turn their lives around

Like Dr. Eliza Hutchinson and Dr. Shawn Andrews, featured in this week’s cover story, Grande has long treated patients in her regular medical practice in Olympia. But those patients have to mostly have their lives together. They need to show up for regular appointments, wear clean clothes, be comfortable in doctors’ offices and be able to navigate the medical system. Many have stable housing and support networks.

That excludes others who could benefit from the treatment, especially people experiencing homelessness.

So all three physicians helped create clinics that turn traditional medicine on its head, bringing care to people where they are. (The one Grande co-founded is the Olympia Bupe Clinic.)


While the number of people getting bupe in Washington is increasing, so, too, is the number of people with opioid addiction. Many are getting quickly hooked by fentanyl, a powerful opiate that is nearly four times deadlier than heroin.

Buprenorphine, also called Suboxone, is effective for most people on fentanyl, but they often need higher doses. For some, the more potent option of methadone treatment might be necessary.

A 23-year-old man I met at the SCORE (South Correctional Entity) jail in Des Moines told me he smoked up to 30 “blues” — fentanyl tablets — a day. “It feels amazing,” he said. “You don’t have any pain whatsoever. You feel like you’re floating in clouds.”

He was taking bupe in jail and was set up to enter a treatment program after release. But he was worried.

“I know when I get out, I’m going to want to hit those blues,” he said. “But I’m going to try to keep on the Suboxone program so I don’t relapse.”