"People still see addiction as a moral failing," Fleming said, "so we have stigmatized an entire population. We fear they will steal from us or hurt us or hurt themselves."

And fear, Fleming said, has become an excuse to rationalize discrimination.

Recovering addicts all have horrific stories of prejudice and abuse to tell — of being given spurious medical treatment, of being fired after they told their employers they were in recovery, of taunting by law enforcement officers all too familiar with their past misdeeds.

One recovering heroin addict recalls how he went to a Salt Lake emergency room with an abscess so bad the doctors considered amputating his arm. The doctor assigned to the case took out a scalpel, sliced the abscess and pressed out the infection — all without anesthesia.

"I was screaming, and he just kept telling me, 'You did this to yourself. It's your own fault.' " he said.

Another addict, now in recovery, recalled hearing nurses talk openly about why they were working to save her life when she was obviously trying to kill herself. "It was like I wasn't even in the room, or maybe they thought I wasn't human," she said.

Fleming has heard the horror stories, too, and he doesn't doubt there is some merit to the complaints.

The irony, he says, is that doctors and nurses are some of Utah's worst abusers of opiates — painkillers, mostly. And they should have more empathy for the disease than anyone.

Fleming believes the prejudice against addicts is rooted in a huge public policy debate that divides the medical and treatment communities.

Doctors and nurses, by and large, have not embraced the shifting perception that "addiction is a disease and needs to be treated like a disease," he said. And it can be treated with a combination of counseling and legal drugs that block the euphoric highs of illegal drugs.

But therein lies the paradox. Prescription drugs that treat addiction are rarely covered by health insurance plans.

And decisions about what is and is not covered are being made by doctors who sit on insurance company advisory boards, not by experts in addiction treatment.

The traditional approach to drug addiction — one covered by many insurance plans — is costly, often involving 30 days treatment at a hospital. Once the 30 days are up, the patient is released with little follow-up care.

Relapses under those approaches are often inevitable.

"The health insurance companies complain the programs are too expensive and they don't work," said Angela Smart, a programs administrator with the state Division of Substance Abuse. "And they are right. That type (of program) doesn't work."