One way to explain the stubbornness of the epidemic is to look at the availability of the maintenance medication buprenorphine, sold most commonly under the brand name Suboxone. Taking the medication (or methadone), along with counseling, is an opioid addict’s best chance for recovery, public health experts say. But in the U.S., doctors cannot treat more than 100 buprenorphine patients at a time.

Nearly half of all 3,100 counties in America have no doctors certified to prescribe buprenorphine by the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration, according to a Huffington Post analysis. Hundreds of counties have very few certified doctors. In places like South Dakota, which has just 27 bupe-certified physicians, some people drive hundreds of miles outside the state to fill prescriptions.