distributed by these companies: McKesson Corp., Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart. Nearly 67 billion (88%) of the drugs were manufactured by SpecGx, a subsidiary of Mallinckrodt; Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals. The greatest number of pills/person were found in West Virginia – 66.5; Kentucky – 63.3; Tennessee – 57.7; and Nevada – 54.7. The highest opioid overdose rate 2006-2012 was in West Virginia. Rural communities were hit particularly hard. 306 pills/person/year were shipped to Norton VA; 242 to Martinsville VA; 203 the Mingo County WV; and 175 to Perry County KY. Treatment The opioid epidemic is often discussed in terms of prevention, but helping those who are already addicted is addressed less frequently. Opioid dependence can lead to a number of consequences like contraction of HIV and overdose. For addicted persons who wish to treat their addiction, there are two classes of treatment options available: medical and behavioral. Neither is guaranteed to successfully treat opioid addiction. Which treatment, or combination of treatments, is most effective varies from person to person. These treatments are doctor-prescribed and -regulated, but differ in their treatment mechanism. Popular treatments include kratom, naloxone, methadone, and buprenorphine, which are more effective when combined with a form of behavioral treatment. Accessing treatment, however, can be difficult. The strict regulation of opioid treatment programs dates back to the early 20th century. Before 1919, physicians prescribed milder forms of opiates to help wean patients off opium. In Webb v. United States, the Supreme Court ruled that doctors could no longer prescribe narcotics to aid in treating a narcotic use disorder. Thus, morphine dispensaries emerged in communities to fill the treatment gap and were the early precedents to modern methadone clinics. It is still difficult for providers to prescribe opioids for medication-assisted treatment despite the data that show individuals addicted to opioids have better outcomes with that than abstinence-based treatment programs. Programs are required to be accredited by SAMHSA or the Drug Enforcement Administration which is a lengthy, time- and resource-consuming process including intensive training and site visit reviews. To stay in operation, they must submit to re-accreditation every 1–3 years. Accredited programs are also able to administer buprenorphine, provided that those prescribing and administering the drug have completed the 8–24 hours of SAMHSA training. Office-based physicians who wish to prescribe buprenorphine for the treatment of opioid use disorder must also complete the required