MARSHALLTOWN (Iowa) • Ms Andrea Steen is one of the fortunate ones. For people in this rural community of 28,000, getting medication to help overcome opioid addiction used to require long drives to treatment centres.

That changed about a year ago when two doctors here were licensed to prescribe Suboxone, a drug that eases withdrawal symptoms and helps keep opioid cravings at bay.

Now Ms Steen is one of their patients, coming once a month to check in and renew her prescription.

This epidemic is different from those of the past in significant ways. One is that it has spawned a growing demand for medications that can help modify the impact of addiction.

Buprenorphine, typically sold as Suboxone, is an example of such medications.

By keeping users from experiencing cravings and withdrawal, Suboxone can make it easier for addicts to stay off heroin and other opioids. The number of doctors certified to prescribe buprenorphine has more than doubled since 2011, to around 36,000 from about 16,000, according to the Substance Abuse and Mental Health Services Administration. Yet the drug remains out of reach for many rural Americans.

Ms Steen, 46, is among 20 patients who get Suboxone from the two doctors authorised to prescribe it here. Until last summer, she said, she abused painkillers Vicodin and morphine relentlessly. She would steal them from her disabled husband, who would try in vain to hide them. But sometimes she couldn't root out the pills fast enough, and she would experience what every addict dreads most: withdrawal.

She heard about Suboxone from a friend in Tennessee. "She could tell when I was high," Ms Steen said. "She was trying to help me."

Besides her doctor visits, Ms Steen must attend group therapy and have regular urine tests. She has mostly stopped craving opioids, for now.

NYTIMES