Expert Insights
All the stories in the news about opioid addiction and the number of fatalities can get depressing, if I’m being honest. But there are people out there who read the stories and they decide to do something about it. Alicia Venable from Richmond, VA is one of those people. She created a nonprofit called Venable Community Services, as she understands personally how hard it is to overcome addiction.
She takes it personally, which is why she hits the streets in Richmond doing outreach with the homeless and with those recently released from jail. She also frequents the streets of public housing to spread the message that there is hope to overcome addiction. To say I admire this woman and her passion to help others grasp recovery is a gross understatement.
How We Rank Listings
Every facility listed on Addictions.com goes through a structured review before it appears in our directory. We verify licensing and accreditation against state health department databases and national accreditation bodies, including the Joint Commission and CARF International. Listings are assessed across the full treatment continuum, from detox and residential care through outpatient services and sober living. We cross-reference each facility against SAMHSA’s National Directory of Mental Health Treatment Facilities and state substance use disorder licensure records. Where available, we include accreditation status, accepted insurance types, and specialty program information so you can compare facilities based on what matters most to your situation. Our directory is updated on a rolling basis as facilities add services, change ownership, or close.
- State licensure and SAMHSA registration verified
- Accreditation status noted where confirmed (Joint Commission, CARF, LegitScript)
- Insurance and payment options listed as reported by each facility
- Specialty programs and levels of care included as disclosed by the provider
Rehab in Richmond: What to Know
Richmond is Virginia’s state capital and an independent city, not part of any surrounding county, at the center of the Richmond-Petersburg metropolitan area. The city sits between Henrico County to the north and east and Chesterfield County to the south and west, with a population of roughly 230,000. Richmond is the urban hub for most of central Virginia’s addiction treatment infrastructure, with 47 rehab facilities operating within city limits. For facilities elsewhere in the state, the Virginia rehab directory covers hundreds of programs across all localities.
The Richmond Behavioral Health Authority (RBHA) is the city’s Community Services Board and public behavioral health authority, licensed by the Virginia Department of Behavioral Health and Developmental Services. RBHA provides mental health, intellectual disability, and substance use services to roughly 13,000 Richmond residents each year. It also serves as the fiscal agent and program coordinator for six surrounding Community Services Boards across central Virginia’s Region 4. Residents who are uninsured or underinsured can access treatment through RBHA on a sliding-scale basis. RBHA accepts Virginia Medicaid and Medicare. For broader treatment options, the addiction treatment options guide explains how different program types compare.
The broader Richmond treatment network includes behavioral health and addiction medicine programs through VCU Health and Bon Secours Richmond Health System. The Hunter Holmes McGuire VA Medical Center on Broad Rock Boulevard serves veterans throughout the region with inpatient and outpatient substance use disorder programs, including medication-assisted treatment at no cost to eligible veterans.
Richmond has faced one of the most acute opioid use disorder crises in Virginia. In 2023 the city was listed by the Virginia Department of Health as one of the localities with the highest overdose death rates statewide, between 104.5 and 129.5 per 100,000 residents. The local drug supply has consistently involved fentanyl mixed with cocaine and other substances, a combination VDH identified as the most common cause of fatal overdoses statewide in 2023. In response, Richmond expanded harm reduction infrastructure, including 24-hour naloxone vending machines installed in public spaces in 2024, and launched a “Spike Alert” early-warning system to notify emergency services when overdose clusters are detected. Virginia’s Good Samaritan law protects anyone who calls for emergency help during an overdose, removing one of the most common barriers to seeking assistance.
Cost of Rehab in Richmond
Publicly available cost data specific to Richmond is limited, but treatment costs in the city broadly track Virginia state averages. Virginia ranks 12th nationally for residential treatment cost, placing it among the more affordable options in the mid-Atlantic region for out-of-pocket payers. For most people with insurance or Medicaid, the figures below represent the ceiling rather than what they will actually pay. Understanding how insurance covers addiction treatment is the most important step before assuming costs are prohibitive.
Actual costs vary based on program type, length of stay, insurance status, and facility characteristics. Most people using insurance or a government benefit pay significantly less, and some pay nothing out of pocket for medically necessary care.
How to Pay for Rehab in Richmond
Of the 47 rehab facilities in Richmond, the majority accept multiple payment types. Forty-three accept self-pay or private cash payment, and 36 accept private health insurance. Government programs cover a significant share of treatment costs for qualifying residents, with 19 facilities accepting Virginia Medicaid and 14 accepting Medicare.
Medicare
Fourteen Richmond facilities accept Medicare. Medicare Part A covers inpatient psychiatric and substance use disorder treatment in a hospital or residential setting, subject to deductibles and cost-sharing. Part B covers outpatient substance use counseling and medication-assisted treatment, including buprenorphine prescriptions from certified physicians. Medicare Advantage plans may offer expanded substance use disorder benefits beyond original Medicare, so confirming what your specific plan covers before enrolling in a program is a worthwhile step.
Medicaid
Nineteen Richmond facilities accept Virginia Medicaid. Virginia expanded Medicaid coverage in January 2019, extending eligibility to adults earning up to 138 percent of the federal poverty level. Coverage for substance use disorder is provided through the Addiction and Recovery Treatment Services (ARTS) benefit, administered by the Virginia Department of Medical Assistance Services (DMAS) through managed care organizations. The ARTS benefit covers the full ASAM continuum of care, including medical detox, inpatient and residential treatment, partial hospitalization, intensive outpatient programs, standard outpatient services, office-based addiction treatment, and peer recovery support. DMAS provides dedicated ARTS Care Coordinators to help Medicaid members navigate referrals and treatment access.
Private Insurance and Self-Pay
Thirty-six Richmond facilities accept private health insurance. Major insurers whose plans frequently cover substance use disorder treatment in Virginia include:
- Anthem HealthKeepers
- Optima Health
- Aetna
- Cigna
- UnitedHealthcare
- Molina Healthcare
- Kaiser Permanente
Coverage levels and in-network facility lists vary by plan. Contacting your insurer directly to confirm which Richmond facilities are in-network before beginning treatment can prevent unexpected out-of-pocket costs.
Military Benefits and TRICARE
Ten Richmond facilities accept TRICARE, the federal health coverage program for active-duty service members, retirees, and their dependents. The Hunter Holmes McGuire VA Medical Center provides comprehensive substance use disorder treatment directly to eligible veterans at no charge, including inpatient detox, residential and outpatient programs, and medication-assisted treatment. For a full overview of benefit options and specialized care, see our guide to rehab resources for veterans and military families.
Sliding Scale and Financial Assistance
Seven Richmond facilities offer sliding-scale fees that adjust costs based on income. Twelve additional facilities offer other forms of financial assistance, including grants, reduced-rate placements, and scholarship funding. RBHA provides sliding-scale services to Richmond city residents who are uninsured or underinsured. Nine Richmond facilities offer financing arrangements for those who need to spread the cost of treatment over time.
Free Treatment Programs
Two Richmond facilities offer free treatment for qualifying individuals. State-funded and nonprofit programs exist for people with no coverage or ability to pay. If cost is the primary barrier to care, rehab scholarships and grants can sometimes cover all or part of treatment costs at participating facilities.
Levels of Care Available in Richmond
Richmond’s 47 treatment facilities provide a broad range of care intensities. Twenty-two offer medical detox, 24 offer inpatient or residential programs, and 39 provide outpatient services, giving the city substantial coverage across the treatment continuum. Twenty-four facilities provide dual diagnosis programming for co-occurring mental health and substance use disorders.
Medical Detox
Twenty-two Richmond facilities provide medical detox, the supervised withdrawal process for people with physical dependence on alcohol, opioids, benzodiazepines, or other substances. Medical detox involves 24-hour clinical monitoring and, where appropriate, medication to reduce withdrawal severity and prevent complications like seizures. It is the recommended entry point for people with alcohol or sedative dependence. Detox alone is not addiction treatment; most programs transition directly into a residential or outpatient program afterward.
Inpatient and Residential Treatment
Twenty-four Richmond facilities offer inpatient rehab, which provides structured, round-the-clock care in a residential setting, typically for 28 to 90 days. Inpatient treatment is appropriate for people with a severe or long-standing substance use disorder, those who have not responded to less intensive care, or those who need a stable environment separated from the circumstances associated with their substance use.
Partial Hospitalization Programs
Two Richmond facilities offer partial hospitalization programs (PHP). PHPs deliver intensive clinical services, typically five to six hours per day, five days per week, while clients return home or to sober living each evening. PHPs are commonly used as a step-down from inpatient care or as a high-intensity option for people who need more structure than standard outpatient provides without requiring an overnight stay.
Outpatient Treatment
With 39 outpatient facilities, Richmond has strong coverage for standard outpatient care. Outpatient programs typically meet several hours per week and are best suited to people with a stable home environment, strong social support, and a mild-to-moderate substance use disorder. Many Richmond outpatient programs integrate medication-assisted treatment for opioid and alcohol use disorders alongside individual and group counseling.
Dual Diagnosis Programs
Twenty-four Richmond facilities treat co-occurring mental health and substance use disorders together. Co-occurring conditions such as depression, anxiety, and trauma-related disorders are common among people seeking addiction treatment, and integrated programs address both simultaneously rather than in separate treatment sequences.
Sober Living Homes
Three Richmond facilities provide sober living homes, which offer structured, substance-free housing for people in recovery who are not yet ready to return to their prior living situation. Sober living bridges residential treatment and independent living, and is associated with better long-term recovery outcomes. Most residents continue outpatient treatment or rehab aftercare programs while residing in sober living.
Specialty Programs in Richmond
Many Richmond facilities offer programs tailored to specific populations or substance types. The counts below reflect facilities that formally identify a specialty, not every facility that serves those populations in a general clinical setting.
Free and Low-Cost Rehab Resources in Richmond
Richmond has a range of public and nonprofit resources for people who need addiction support and cannot access or afford private treatment. If you or someone you care about is in immediate crisis, calling or texting 988 connects to the Suicide and crisis support lifeline around the clock, including for substance use emergencies.
Crisis Lines
- 988 Suicide and Crisis Lifeline — Call or text 988. Free, confidential, 24/7 crisis support for mental health and substance use emergencies. Available in English and Spanish. 988lifeline.org
- SAMHSA National Helpline — 1-800-662-4357. Free, confidential, 24/7 treatment referral and information service for people with substance use disorders and their families. samhsa.gov
- RBHA Crisis Line — 804-819-4100. Richmond Behavioral Health Authority provides 24/7/365 crisis intervention, triage, referrals, and mobile outreach for Richmond city residents. Clinicians are available around the clock. rbha.org
City Health Department
- Richmond City Health District — 400 E. Cary St., Richmond. Call 804-845-6000. Provides free naloxone kits through walk-in distribution (Mondays, 8-10 a.m.) and the REVIVE! rapid naloxone training program, a free seven-minute online course that results in free naloxone nasal spray with no registration required. vdh.virginia.gov/richmond-city
Harm Reduction
- Health Brigade — Richmond. Offers a needle exchange program, free naloxone kits, HIV and hepatitis C testing, PrEP, and wound care. Referrals to substance use treatment are available for interested clients. Services are free and confidential. healthbrigade.org
- REVIVE! Program (Virginia Department of Health) — A free statewide opioid overdose and naloxone education program. The rapid online training takes seven minutes and results in free naloxone nasal spray without prior registration. Available at any time. revive.virginia.gov
Veterans and Military
- Hunter Holmes McGuire VA Medical Center — 1201 Broad Rock Blvd., Richmond, VA 23249. Call 804-675-5000. Offers inpatient and outpatient substance use disorder treatment, medication-assisted treatment, and PTSD clinical services to eligible veterans at no charge. va.gov/richmond-health-care
General Referrals and Public Behavioral Health
- Virginia 211 — Dial 211 from any Virginia phone or text your zip code to 898-211. Connects callers to local social services including addiction treatment, mental health programs, housing assistance, and food resources. 211virginia.org
- Richmond Behavioral Health Authority (RBHA) — 107 S. 5th St., Richmond. General information line: 804-819-4000 (Monday through Friday, 8 a.m. to 5 p.m.). Substance use services provided on a sliding-scale basis to Richmond city residents. Accepts Virginia Medicaid and Medicare. rbha.org
Drug and Alcohol Use Statistics in Richmond
Richmond has been among Virginia’s hardest-hit localities during the fentanyl crisis. In 2023 the city reported close to 300 drug overdose deaths, its highest recorded total, and was identified by the Virginia Department of Health as one of the localities with the highest overdose death rates in the state. The most common lethal drug combination in Richmond’s drug supply that year was fentanyl mixed with cocaine, mirroring a pattern documented across the broader region. Since 2023, statewide numbers have dropped substantially. Virginia recorded a 37 percent decrease in total drug overdose deaths in 2024, the second-largest year-over-year decline of any state nationally. Local providers, however, have noted that service demand in Richmond remains high and the underlying conditions driving substance use have not been fully resolved.
Resources
- Virginia Department of Health. (2025). Drug Overdose and Substance Use: Drug Overdose Data. https://www.vdh.virginia.gov/drug-overdose-data/
- Virginia Department of Health, Office of the Chief Medical Examiner. (2025). Fentanyl-Related Deaths in Virginia, 2024 Preliminary Data. https://www.vdh.virginia.gov/drug-overdose-data/
- Virginia Department of Health. (2024). Fatal Drug Overdose Quarterly Report, Q2 2024: Localities with Highest Overdose Death Rates. https://www.vdh.virginia.gov/drug-overdose-data/
- Virginia Department of Medical Assistance Services (DMAS). (2024). Addiction and Recovery Treatment Services (ARTS). https://www.dmas.virginia.gov/for-providers/benefits-services-for-providers/behavioral-health/addiction-and-recovery-treatment-services/
- Richmond Behavioral Health Authority (RBHA). (2025). Crisis Response Services. https://www.rbha.org/services/crisis-response.aspx
- RVA Magazine. (2025). Overdose Deaths Fall in Virginia, but Richmond Providers Warn of Strain. https://rvamag.com/community/overdose-deaths-fall-in-virginia-but-richmond-providers-warn-of-strain.html
- Addictions.com. (2025). Drug and Alcohol Rehabs in Virginia: Cost and Facility Data. https://www.addictions.com/rehabs/virginia/
