Johnson City, Tennessee, is presented as a border-area hub in the book’s account of opioid treatment and medication diversion. Its significance lies in the contrast between concentrated buprenorphine prescribing and the limited availability of other forms of treatment across the surrounding region.

A Cross-Border Prescribing Center

Just over the Virginia border, Johnson City had offices belonging to several of the country’s leading buprenorphine prescribers. The book uses the city to show how treatment medication could circulate beyond the clinic: Sarah Melton recalled a cash-only prescriber publicly acknowledging that patients received enough buprenorphine to sell some and remain in treatment. The anecdote identifies a practice associated with one prescriber, not a finding about every clinic in Johnson City.

Diversion and Treatment Tensions

The account places Johnson City within a wider dispute over buprenorphine’s role in recovery. Medication could help people stay in treatment, yet its resale and nonmedical use intensified suspicion among law-enforcement officials and others already wary of medication-assisted care. Johnson City’s concentration of prescribers therefore figures both as a source of treatment access and as a point where concerns about diversion became visible.

Distinguishing the Regional Clinic

Johnson City also serves as a geographic reference for a separate initiative: Overmountain Recovery was being established in a rural town between Johnson City and Kingsport, not in Johnson City itself. The planned clinic was designed to combine medication with counseling and other supports; it would primarily offer methadone, in part because the nearest methadone facility in the region was about sixty miles away. The distinction underscores the uneven distribution of treatment options around Johnson City: prominent buprenorphine prescribers were present nearby, while access to methadone remained distant.