Just 29% of residential treatment facilities in the United States offer the opioid addiction medication buprenorphine, a new study finds. An additional 21% of treatment centers discourage its use, according to a survey of 368 programs.

The study, published in JAMA, used “secret shoppers” posing as uninsured 27-year-olds who used heroin. They called both private and government-run addiction treatment facilities.

Lead author Dr. Michael Barnett of Harvard University’s Chan School of Public Health said buprenorphine should be a basic part of addiction treatment. “That’s a very low bar to pass and still most facilities aren’t meeting it,” he told WBUR. “As a physician, I’ve seen how medications like buprenorphine can let my patients with an addiction really lead normal lives. It’s a medication just like anything else we use to treat an illness, whether we use an antidepressant for someone who has depression or insulin for someone who has diabetes.”