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Across the 50 states and the nation’s capital, the hardest-hit places tend to dispense the most buprenorphine, a medication that binds to opioid receptors in the brain to alleviate withdrawal symptoms while avoiding the dangerous effects of heroin, fentanyl, and other opioids. Washington, D.C. breaks the pattern. It dispenses the drug to patients at a rate far below what the city’s overdose burden would predict, a clear statistical outlier, even though the medication reaches its pharmacies at ordinary rates.