Virginia Board of Medicine

The Virginia Board of Medicine is presented in Dopesick through two distinct forms of medical regulation: disciplinary oversight of a physician and guidance on medication-assisted treatment during pregnancy. Together, these episodes place the Board within a changing clinical landscape in which prescribing practices, judgments about medication risk, and access to treatment did not always move at the same pace.

Physician oversight

The book records that the Board suspended Dr. Dwight Bailey’s license in 2014 amid prescription-drug allegations. That account situates the Board in the state’s response to concerns about prescribing, while preserving the distinction between allegations and a more detailed account of the Board’s findings: the evidence provided does not describe the proceedings or specify the terms of the suspension.

Guidance for treatment during pregnancy

In 2017, Virginia Board of Medicine guidelines recommended that pregnant patients use Subutex for no more than seven days before transitioning to Suboxone. The recommendation marked a change in guidance around medication-assisted treatment during pregnancy, rather than a rejection of treatment with buprenorphine.

The clinical context

The book describes why the choice between these medications had particular importance for pregnant patients. Subutex contains buprenorphine without naloxone; at the time, it was considered safer for the baby, but more susceptible to misuse by the mother. Suboxone, which combines buprenorphine with naloxone, was generally preferred for opioid users. The Board’s seven-day recommendation therefore set a limit on the use of one formulation before transition to the other.

That guidance emerged amid substantial barriers to treatment. The account describes Virginia patients facing cash-only clinical visits, high out-of-pocket costs, and waiting lists, even when insurance covered much of the medication. The Board’s recommendations addressed clinical practice; the book presents these financial and service-access obstacles as a separate part of the treatment landscape, not as policies established by the Board.

Role in the book

The Board’s appearances connect professional oversight with evolving treatment standards: one concerns allegations involving a physician’s prescribing, while the other concerns how clinicians should manage medication during pregnancy. The distinction matters in the book’s broader account of the opioid crisis. Formal guidance could change as clinical standards developed, but its existence alone did not ensure that patients could promptly obtain affordable, continuous care.