Addiction Treatment Options

Detox, residential rehab, outpatient programs, medications, therapy, telehealth: read enough and the options blur into one another. This guide separates them by how much support each gives and who it is built for, then follows the questions that decide between them, from the assessment to the family’s part to the ways people pay. It ends on what research shows about recovery, including how often a return to use happens and what that means for a plan.

Your Path Through Addiction Treatment

Addiction treatment usually runs as a series of steps rather than one decision, and people move between them as their circumstances change. No single treatment fits every person. Which step comes first depends on an assessment, and the steps are not a fixed ladder.

Reaching out can begin with one person, and you do not need a plan in place first. Four common starting points are your own doctor, the SAMHSA National Helpline at 1-800-662-HELP (4357), FindTreatment.gov, and the Addictions.com helpline (800-681-1058 Sponsored), which is toll-free and staffed by people who work in treatment.

An assessment comes next: a conversation with a doctor or an addiction professional about what you use, your physical and mental health, and where and how you live. It is how a clinician judges whether a substance use disorder is present, how severe it is, and which kind of substance use disorder treatment fits. Many of them work through the six dimensions of the ASAM Criteria.

Detox, or withdrawal management, is where a substance leaves the body and withdrawal symptoms are managed, sometimes with medication. Medically assisted detoxification is only the first stage of drug addiction treatment, not the treatment itself. Heavy drinking or regular benzodiazepine use makes a sudden stop risky, and withdrawal from either can be dangerous enough to need medical guidance. When withdrawal is dangerous, it can involve seizures or confusion.

Rehab is the next step for many people: a residential or outpatient program with structured therapy and support. Among adults who received treatment, an outpatient setting was the most common one (2025 NSDUH, SAMHSA, 2026). Residential care means living at the program for a time, while outpatient care fits around work and home.

Behavioral therapy runs through these steps, in groups or one-to-one sessions, and it builds skills for handling triggers, relationships and daily life. Some programs pair it with medication for withdrawal or cravings.

Aftercare, or continuing care, is what follows a program: ongoing therapy, mutual-support groups, recovery housing and check-ins. Among adults who described drugs or alcohol as ever having been a problem for them, 73.0%, or 22.3 million people, counted themselves as in recovery or as having recovered (2025 NSDUH, SAMHSA, 2026).

Levels of Care: Comparing Your Treatment Options

Levels of care describe how much treatment someone gets and where it happens, from a hospital room staffed around the clock to a weekly counseling session. A clinician matches a person to a level with a standard assessment, usually the ASAM Criteria. No level ranks above another, and people often step down to outpatient care as they stabilize.

The hour figures are Medicare’s coverage minimums, not a schedule every program keeps. Medication-assisted treatment (MAT), or medications for opioid use disorder (MOUD), can be part of care at any level. Length matters as much as the starting level: most people with a substance use disorder need at least three months in treatment to significantly reduce or stop their drug use.

Residential or Outpatient Care?

Inpatient rehab, also called residential rehab, means living at the program, with treatment and support around the clock. Outpatient rehab means living at home and attending scheduled sessions. Which one fits depends on the assessment, on how safe and supportive home is, and on work, school or family duties.

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What Happens During an Addiction Assessment

An assessment is a conversation, typically with a doctor or another addiction professional, about how you use substances, your physical and mental health, and the living situation you go home to. What the clinician learns establishes whether a substance use disorder is present and how severe it is, then points to a level of care that fits.

Many clinicians work through the six ASAM dimensions to organize their questions and the risks they weigh. Those dimensions take in physical health, mental health, substance use and the surroundings you live in.

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For a sense of how intake and the days that follow unfold, read what happens in rehab.

Medications for Addiction Treatment

The Food and Drug Administration (FDA) has approved medications for opioid use disorder (OUD) and alcohol use disorder (AUD), and they work best with counseling. The five are acamprosate, disulfiram, naltrexone, methadone and buprenorphine.

Those medications can treat a substance use disorder, support recovery and prevent an overdose. Which one fits is a decision made with a prescriber, and treatment can begin at any level of care, including detox. The approach is also called medication-assisted treatment.

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For other substances, care centers on behavioral therapy and symptom relief. As of October 2023, the FDA had approved no medication for stimulant use disorder.

Medications for Opioid Use Disorder (MOUD)

The FDA has approved buprenorphine, methadone and naltrexone for opioid use disorder, and all three have been shown to be safe and effective. They work in different ways and settings, so the choice is one a person makes with a prescriber. Methadone is dispensed only through a SAMHSA-certified opioid treatment program (OTP). Buprenorphine treatment is prescribed or dispensed in physician offices. Extended-release injectable naltrexone is approved for both OUD and AUD, and any prescriber licensed to prescribe can administer it.

For prescription drug addiction, the treatment depends on the drug. The same medications also treat an opioid use disorder that began with a prescription, and benzodiazepine dependence calls for a supervised taper that a prescriber sets.

Naloxone works in an emergency, not as ongoing treatment. It can bring back normal breathing in 2 to 3 minutes when an opioid overdose has slowed or stopped a person’s breathing, and in March 2023 the FDA approved the first naloxone nasal spray for sale without a prescription.

If you think someone is overdosing, call 911 and give naloxone if you have it.

Medications for Alcohol Use Disorder

Three medications are currently approved by the FDA to help people stop or reduce drinking and prevent a return to drinking: naltrexone, in oral and long-acting injectable forms, acamprosate and disulfiram. They are used alongside counseling or mutual-support groups as part of alcohol addiction treatment.

Behavioral Therapies for Addiction

Behavioral therapies target the thinking, routines and circumstances around substance use, and counseling for an individual, a family or a group is among the forms of treatment used most often. Most programs offer more than one.

CBT began as a way to prevent relapse in people being treated for problem drinking, then was adapted for other substances. Contingency management means pairing tangible rewards with positive behaviors such as abstinence, while motivational enhancement therapy is a counseling approach that helps a person sort out mixed feelings about treatment and about stopping drug use.

Twelve-step facilitation works as an active engagement strategy aimed at raising the odds that someone joins a 12-step group; Family Behavior Therapy has shown positive results among both adults and adolescents.

Therapy rarely stands alone. Good programs also help with medical care, mental health, family relationships, work and legal problems.

Telehealth Addiction Treatment

Much of addiction treatment can happen by video or phone: counseling, therapy groups, check-ins and some medication care.

The clearest rules cover buprenorphine treatment for opioid use disorder: since December 31, 2025, a Drug Enforcement Administration (DEA) rule allows an initial six-month supply by telemedicine, including audio-only visits, once the prescriber checks the state prescription drug monitoring program. Later prescriptions need another telemedicine route or an in-person visit.

As of October 2026, the DEA and the Department of Health and Human Services (HHS) keep flexibilities for other controlled substances through December 31, 2026. Methadone still comes from an opioid treatment program, whose rules changed in 2024.

Medicare coverage for addiction treatment includes telehealth behavioral health care permanently, and home is an approved site for substance use disorder treatment. The remaining temporary waivers stay in place until December 31, 2027. Medicare covers intensive outpatient care in person only.

Regular office or telehealth visits are outpatient rehab. An assessment decides whether telehealth fits, which matters more where withdrawal could be severe. Ask what a program offers remotely, and what your plan covers.

Aftercare and Recovery Support

The work of treatment continues after a program ends. Aftercare, or continuing care, covers what comes next: therapy sessions, mutual-support groups, recovery housing and regular check-ins with a care team. It is usually planned before a person leaves, and it changes as life does.

In 2025, according to the 2025 NSDUH (SAMHSA, 2026), 30.6 million adults reported that drugs or alcohol had at some point been a problem for them, and 22.3 million of those adults describe themselves as in recovery or as having recovered.

A return to use does not mean the treatment failed. It means the plan needs adjusting, whether that is a different setting, a review of medication or more frequent contact with a care team.

Some people move into recovery housing, a shared home for people in recovery with house rules and some structure, before living on their own again. Others keep to outpatient counseling and a group, then taper the schedule as the first year settles.

Treatment for Co-Occurring Mental Health Conditions

A substance use disorder often appears alongside a mental health condition. When the two co-occur, treatment should address both (or all).

In 2025, 18.5 million adults had both a substance use disorder and any mental illness, according to the 2025 NSDUH (SAMHSA, 2026). Of those adults, 57.4%, or 10.6 million people, received either substance use treatment or mental health treatment that year.

An assessment that covers mental health as well as substance use is the usual entry point, and co-occurring disorder treatment can pair therapy with medication and psychiatric care. Attention-deficit/hyperactivity disorder (ADHD) is another common pairing worth raising at intake, alongside the ADHD and addiction question.

Helping a Loved One Get Treatment

Family and friends can play a critical part in getting a person with a drug problem into treatment and helping them stay there. That part is easier to hold with clear information and some support of your own.

Four things you can do:

• Learn what the treatment options are, so the conversation can be specific rather than abstract.
• Describe what you have noticed and how concerned it makes you, without assigning blame.
• Get support for yourself, such as a support group for families or a counselor who works with relatives.
• When the person turns down help, a professional can advise on a guided intervention.

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You can also contact the Addictions.com helpline (800-681-1058 Sponsored) or the SAMHSA National Helpline to ask what options fit someone else.

Paying for Addiction Treatment

Most health insurance covers addiction treatment; every Marketplace plan must. Mental health and substance use care are among the essential health benefits a plan must include.

Plans that cover substance use disorder must keep those benefits on par with medical ones under the Mental Health Parity and Addiction Equity Act (MHPAEA), which governs how insurance covers rehab. The 2024 rule’s added requirements are not being enforced, the departments that enforce parity said in May 2025.

Medicaid is the largest single payer for mental health and substance use care.

Medicare coverage for addiction treatment has included intensive outpatient programs under Part B since January 1, 2024, at 9 or more hours weekly, with 20% coinsurance once the deductible is met, according to Medicare.gov. Opioid use disorder care at an opioid treatment program usually has no copay, CMS says.

Getting into rehab with no money often starts with a sliding-fee scale many providers set by income. Check benefits before an intake call.

Choosing a Treatment Program

Match the program to the level of care the assessment points to, and confirm it is licensed to provide that care. Signs of a solid program include evidence-based therapy, medication when a person needs it, treatment for co-occurring mental health conditions, and an aftercare plan made before discharge.

Before you commit, three checks matter more than the brochure:

Since some programs are designed around a particular age group, gender or language, ask whether a given one is right for you. Guidance for particular groups covers veterans, LGBTQ+ people and rural communities, and FindTreatment.gov can find treatment facilities by location.

Does Addiction Treatment Work? Myths and Facts

Yes, for many people it does, and recovery is common. Substance use disorder is a chronic condition, and NIDA’s Treatment and Recovery page reports relapse rates of 40-60% for drug addiction, against 50-70% for hypertension and asthma. A return to use calls for adjusting the plan, not for deciding that treatment failed.

Treatment does not need to be voluntary to be effective. For opioid use disorder, the FDA has approved buprenorphine and methadone, which differ in how they are dispensed and monitored.

Addiction Treatment FAQ