BRAIN CHEMISTRY. AND WITH GRUELING WITHDRAWAL, MOST DOCTORS WILL TELL YOU OPIOID ADDICTION CAN’T BE OVERCOME WITHOUT MEDICATION ASSISTED THERAPY. BUT KETV DISCOVERED ACCESS TO THE THREE MAIN MEDICATIONS THAT OPIOID USE DISORDER AREN’T SO EASY TO COME BY. IN NEBRASKA. QUANECIA FRASER EXPLAINS THE DIFFERENCES THOSE MEDICATIONS AND INTRODUCES US TO ONE WOMAN WHO SAYS FINDING THE RIGHT ONE SAVED HER LIFE. FOR SHANDA KOEHLER, HER FIRST ENCOUNTER WITH OPIOIDS STARTED DECADES AGO. 2000 WAS WHEN I WAS GETTING PRESCRIPTIONS. I TAKING PILLS, POPPING PILLS, OTHER PEOPLE’S PILLS. BEFORE THAT, JUST KIND OF LIKE, YOU KNOW, FOR RECREATIONAL PURPOSES. IN 2000, KOEHLER SAYS SHE FELL WORK AND HURT HER BACK. ONE OF MY DOCTORS SAID, HEY, I GOT SAMPLES AND IT WAS TRAMADOL. AND HE SAID, HEY, WHY DON’T YOU TRY THIS? AND THEN IN 2013, KOEHLER WAS A MOTORCYCLE CRASH. I JUST FELL OVER ON MY BIKE AND I HIT MY HEAD AND I TORE AN ARTERY IN MY HEAD. AND I HAD, LIKE, A STROKE. THAT’S WHEN SHE SAYS SHE STARTED GETTING ON HEAVIER OPIOIDS. AT ONE POINT SHE WAS ON OXYCONTIN OXYCODONE AND TRAMADOL THE SAME TIME. I REALIZE THERE WAS A PROBLEM WHEN MY FATHER DIED. MY FATHER DIED AND. HE HAD SOME LEFTOVER OPIOIDS. I STARTED TAKING HIS PULSE. FOR MORE THAN 20 YEARS, KOEHLER SAYS SHE FELT LIKE OPIOIDS CONTROLLED HER LIFE. I WOULD PLAN MY ACTIVITIES AROUND WHEN I WAS GOING TO HAVE MY PILLS, AND I WOULD IF I RAN OUT. I YOU KNOW, IT WAS LIKE A NIGHTMARE. BUT AS OF OCTOBER, KOEHLER SAYS, SHE’S BEEN SOBER FOR A YEAR AND SHE GIVES THE CREDIT TO A MEDICAL PERSON CALLED METHADONE. IT WAS THE TO GETTING ME ON THE ROAD TO RECOVERY. I DIDN’T HAVE TO SUFFER. I DIDN’T HAVE TO GO THROUGH. I MEAN, WITHDRAWALS ARE TORTURE. AND THAT’S PEOPLE DON’T GET OFF IF THEY’RE SCARED. THEY DON’T WANT TO GO THROUGH THAT EVERY DAY. KOEHLER TAKES HER ASSIGNED DOSE. YOU JUST TAKE IT AND YOU. TASTE. BUT WHEN SHE FIRST STARTED, SHE HAD TO GO DIRECTLY TO AN APPROVED OPIOID TREATMENT AND CONSUME THE MEDICATION IN PERSON EVERY DAY. DR. KENNETH SUHA SAYS CAN’T BE PRESCRIBED BY PRIMARY DOCTOR. BUT KETV INVESTIGATES DISCOVERED IT’S ONLY AT JUST THREE CLINICS IN THE ENTIRE STATE. WE HAVE ONE IN LINCOLN AND TWO IN OMAHA RIGHT NOW THAT ARE DOING WORK. SO IF YOU’RE OUTSIDE OF THOSE AREA, IT CAN BE PRETTY TOUGH. ZOHAR IS, A MEDICAL DOCTOR AT UMC AND MEDICINE SPECIALIZING IN ADDICTION MEDICINE. HE SAYS IS ONE OF THREE MEDICATIONS USUALLY OFFERED TO PEOPLE STRUGGLING WITH SUBSTANCE DISORDER. EVERY PATIENT IS DIFFERENT. AND SO WHAT WORKS FOR PATIENT MAY NOT WORK FOR ANOTHER PATIENT. ANOTHER MEDICATION IS BUPRENORPHINE, BETTER KNOWN AS SUBOXONE. IT COULD BE MORE WIDELY, BUT PROVIDERS NEED A SPECIAL TO PRESCRIBE IT. THAT’S A MEDICATION THAT CAN BE PRESCRIBED BY A PHYSICIAN IN P.A. AND NURSE PRACTITIONERS, OTHER NURSE SPECIALISTS THAT CAN ALSO PRESCRIBE THAT. ZOHAR SAYS A THIRD OPTION NALTREXONE, KNOWN BY THE BRAND NAME VIVITROL, BLOCKS THE EUPHORIC EFFECTS OF OPIOIDS. IT CAN BE GIVEN AS A PILL TAKEN ONCE DAILY OR IN THE FORM A SHOT GIVEN ONCE A MONTH. BUT HE SAYS, A LOT OF PATIENTS STRUGGLE MAKE IT THROUGH THE WITHDRAWAL NEEDED TO TAKE. THE DOWNSIDE TO THAT IS THAT YOU HAVE TO BE OFF ALL OF YOUR OPIOIDS FOR 10 TO 14 DAYS. KOEHLER SAYS IT’S TIME TO ADDRESS STIGMA, NOT JUST SURROUNDING SUBSTANCE USE DISORDER, BUT ALSO WHEN IT COMES TO USING MEDICATION AND TO TREAT WHAT DOCTORS LIKE SUHA SAY IS A DISEASE AND NOT A CHARACTER FLAW. THEY HAVE CHANGED WITH BRAIN FUNCTION THAT MAKE IT SO THAT THEY HAVE COMPULSIVE BEHAVIORS, CONTINUED SUBSTANCE USE. DESPITE NEGATIVE CONSEQUENCES. I MENTIONED SUBOXONE, ZOHAR SAYS BEFORE APRIL 2021, PRESCRIBE BOYS HAD TO DO HOURS OF TRAINING TO GET SPECIAL WAIVER TO TREAT OPIOID DISORDER. BUT NOW IF THEY’RE TREATING 30 PATIENTS OR LESS, THEY CAN SKIP THE TRAINING AND JUST REQUEST THE WAIVER. SO WHY AREN’T MORE DOCTORS DOING THAT? NEBRASKA AND HOW DIFFICULT IS IT TO GET ACCESS TO THESE LIFE MEDICATIONS? I EXPOSED THOSE CONCERNS IN PART TWO OF M