How to find addiction treatment that fits

Hunter Michael Shepard overcame addiction in the heart of the opioid epidemic and now works as a trained addiction interventionist. He also founded findingrehab.io, a free directory of more than 17,000 addiction and mental health treatment programs across the United States, showing the Medicaid, Medicare and private insurance each one lists.

Start with an assessment

No single type of treatment is right for everyone. FindTreatment.gov, run by the federal agency SAMHSA, explains that everyone entering treatment gets a clinical assessment to find the best fit. A primary care doctor is a good first stop: the National Institute on Drug Abuse (NIDA) suggests talking to your health care provider, who can screen for a substance use disorder and refer you.

The most widely used placement standards, the ASAM Criteria from the American Society of Addiction Medicine, match each person to a level of care based on a full assessment, then move them to more or less intensive care as their needs change.

Levels of care, in plain words

These short definitions, from care around the clock down to a weekly visit, draw on SAMHSA's guide to types of treatment.

Detox

Detox helps the body clear a substance while withdrawal symptoms are treated. FindTreatment.gov is clear that detox by itself is not treatment; it is a first step. NIDA adds that detox alone, without treatment afterward, generally leads back to drug use. Withdrawal can be dangerous, so let a doctor guide it.

Inpatient and residential

Inpatient care means staying overnight in a hospital or treatment program for a few days or weeks, usually for people who need care around the clock. Residential care means living at a program, usually for a few weeks to a few months, and sometimes a year or more for serious conditions.

Partial hospitalization and intensive outpatient

These are structured programs where the person still goes home the same day. They combine individual sessions, groups and coping skills work, usually for at least a few hours at a time. Partial hospitalization, also called day treatment, is the more intensive of the two: SAMHSA's national survey of treatment facilities (PDF) counts it as 20 or more hours a week, and intensive outpatient as 9 or more.

Outpatient

Standard outpatient care means regular office or telehealth visits for counseling, medication, or both. FindTreatment.gov notes that it works best for people who can keep regular appointments and have a stable home, reliable transportation and supportive people.

findingrehab.io's guide to levels of care explains each one in more detail, including sober living and virtual care.

Medications for opioid use disorder work

If opioids are involved, ask every program about medication. The FDA has approved three medications for opioid use disorder: buprenorphine, methadone and naltrexone, and it says all three have been shown to be safe and effective. NIDA says that for opioid addiction, medication should be the first line of treatment, usually combined with counseling.

SAMHSA calls these medications evidence based treatment options that do not just substitute one drug for another, and reports that this approach improves survival, helps people stay in treatment and reduces illegal opioid use. Methadone is only given through certified opioid treatment programs. Which medication is right is a decision to make with a doctor.

Paying for treatment

Cost should not stop anyone from looking. FindTreatment.gov points out that there are free and low cost programs across the country, that many others accept Medicaid or private insurance, and that every state has funding to help people without insurance.

Private insurance

Call the number on the back of the card. Ask which kinds of care are covered, what the deductible and copays are, how many days or visits are covered, and for a list of preferred programs. SAMHSA notes that most plans cover treatment but some only cover certain levels of care, and that plans covering mental health and substance use must pay for it at a level comparable to medical and surgical care. You can search programs that list private insurance, and follow findingrehab.io's steps to verify rehab insurance coverage before admission.

Medicaid and Medicare

Medicaid covers some substance use treatment, but what it pays for depends on your state. Medicare covers treatment too, including opioid use treatment; if you have a Medicare Advantage plan, check with the plan directly. On findingrehab.io you can search programs that list Medicaid or programs that list Medicare, then confirm your plan.

Self pay or no insurance

SAMHSA suggests asking programs about a sliding fee scale, payment plans and scholarships. FindTreatment.gov warns that some scholarships do not cover a whole stay and can be withdrawn if the person does not finish, so ask about the terms first. Your state substance use agency can explain help for people without insurance, and if you have a job, an Employee Assistance Program is a free, confidential service paid for by your employer that can help with drug or alcohol use. findingrehab.io's guide to paying for treatment goes deeper.

Questions to ask a program

A short call tells you a lot, and it is confidential. These questions build on FindTreatment.gov's suggested questions and SAMHSA's quality checklist below. Write down the answers to compare programs:

• When can care start, and what happens while we wait?
• Do you take our insurance? What will we owe, and will you put it in writing?
• Are you licensed by the state and accredited?
• Which therapies do you use, and who provides them?
• Do you offer medications for opioid or alcohol use disorder, or work with a doctor who does?
• Can you treat mental health conditions at the same time?
• How do you involve family, and what contact is allowed?
• What is the plan after discharge?

findingrehab.io has a printable list of twelve questions to ask a treatment program, and The Addiction Intervention Co. covers choosing a treatment center from a family's point of view.

Red flags to watch for

SAMHSA cautions that not all programs provide quality care. Its checklist looks for licensing and accreditation, evidence based therapies, FDA approved medications, family involvement, and support for the rest of a person's life. Be cautious when a program:

• Cannot show a state license or accreditation. Every facility listed on FindTreatment.gov is licensed by its state.
• Promises a cure or guaranteed results. NIDA explains that treatment manages addiction rather than curing it, and the FDA lists claims like "miracle cure" and "guaranteed results" among the warning signs of health fraud.
• Sells unapproved pills or supplements for opioid withdrawal or addiction. The FDA and FTC have warned companies selling unapproved opioid products with deceptive claims.
• Treats detox as the whole plan.
• Pushes someone off medication for opioid use disorder. SAMHSA says these medications are safe for long term use and that people should talk to their doctor before stopping them.
• Cannot see you within 48 hours. FindTreatment.gov suggests trying another facility.
• Will not give clear answers about cost. SAMHSA notes that programs are used to talking about costs.
• Shuts family out even when your loved one wants you involved.

Use FindTreatment.gov

FindTreatment.gov is SAMHSA's confidential and anonymous resource for finding treatment for mental health and substance use disorders in the United States and its territories. Its listings are licensed, certified or approved by state authorities, and you can find programs near your home, including ones that offer payment assistance. It does not endorse specific programs, so the questions above still matter.

If you would rather talk to someone, SAMHSA's National Helpline at 1 800 662 4357 is free, confidential and open 24/7 in English and Spanish, with referrals to local treatment and support groups.

Related guides

• How to help someone with addiction
• What is an addiction intervention?
• More resources from Hunter