Work out which treatment you actually need

Most people researching addiction treatment are handed a list of facilities before anyone explains the choices. This site does the other half: what the levels of care mean, what your insurance is likely to cover, and what to do when the person who needs help has not agreed to it yet.

We do not run treatment centres, we do not sell placements, and we do not take calls on behalf of facilities. Every page cites its sources, and how we research and publish is documented in full — including the figures we count ourselves and what we refuse to put on the site.

The five levels, in one picture

Treatment is sorted into levels of care, and almost every decision you will be asked to make is really a question about which one fits. Here is the whole ladder at a glance.

Weekly structured hours by level. Most people move down this ladder rather than starting at the top — and the honest question at every step is whether the hours not covered are safe.

Start with the choice in front of you

Sober Living Home vs Halfway House
Sober living is privately paid and open-ended; a halfway house is usually assigned with a fixed time limit. Cost, rules, testing and stay length compared.
PHP vs IOP
PHP runs 20-30 structured hours a week and IOP runs 9-19, but the real question is whether home can hold the other 148 hours. Compared against ASAM levels.
Detox vs Rehab
Detox manages withdrawal safely, rehab treats why the drug or alcohol use started, and detox alone rarely holds. What each stage does, how long, and when.
Suboxone vs Methadone
Methadone needs a certified programme with daily visits at first, while Suboxone comes from a regular prescriber. Both work, so access usually decides it.

All comparisons →

Before treatment starts

How to Get Someone Into Rehab
You usually cannot force an adult into addiction treatment. What works is removing the obstacles, picking the moment, and knowing the legal exceptions.
Paying for Rehab Without Insurance
State-funded programmes, sliding-scale fees, federal block grants and payment plans. What each option actually is, who qualifies, and how to reach it.
Rehab Rules: What You Can and Cannot Do in Treatment
What treatment facilities restrict and why: phones, visitors, relationships, leaving early. Rules vary by level of care, so here is what to ask first.
Opioid Withdrawal Timeline: What Happens, and When
Symptoms start around 12 hours after short-acting opioids and 30 after methadone. Fentanyl changes the picture, and the real danger comes after it ends.

Check what your plan covers

Coverage lives in your specific plan, not in the name of your insurer. These pages give you the exact questions to ask so the answer you get is the one that governs your bill.

Bar chart of how many US treatment facilities offer each level of care: outpatient 85.4%, residential 21.4%, medical detox 19.5%, hospital inpatient 5.9% — Outpatient care is nearly universal; residential and detox are the scarce tiers. That scarcity is part of why they cost what they do and why waits exist.

Bar chart of payment types accepted by US addiction treatment facilities: cash 91.6%, private insurance 80.7%, Medicaid 83.4%, Medicare 55.2%, state-financed 54.5%, military 49.6%, sliding scale 40.0%, payment assistance 22.5% — Accepting your insurer is not the same as your plan covering the level of care you need. The two questions have to be asked separately.

Bar chart of medication for opioid use disorder availability: buprenorphine at 59.2% of facilities, methadone at 13.7%, certified opioid treatment programmes at 12.8% — The four-to-one gap between buprenorphine and methadone availability is a regulatory fact, not a clinical judgement about which works better.

Where most people actually start

Four questions account for nearly everything people search about addiction treatment, and they arrive in a fairly predictable order. Knowing which one you are on saves reading three pages that answer a different question.

“They will not go. What do I do?”

The randomised evidence here is clearer than the television version suggests: teaching the family member behaviour-change skills engaged 64% of initially unmotivated people, against 30% for the confrontational family meeting. What the trials found — including the result that the family member benefits either way.

“Which kind of treatment do we even need?”

Two of the six assessment dimensions decide most cases: whether stopping is medically dangerous, and whether home is where use happens. Inpatient against outpatient is the fork almost everyone reaches first.

“Will insurance pay for it?”

Almost always the honest answer is that it depends on the plan rather than the insurer, and on four separate gates being cleared in order. What your plan covers sets out the four and the questions that get each one answered.

“What if there is no money at all?”

Federal rules give some people admission deadlines rather than a place in a queue, and 40% of facilities operate a sliding fee scale that is almost never volunteered. Paying without insurance works through the routes in the order that changes the number.

Bar chart of dedicated programming reported by US treatment facilities for older adults, women, men, trauma-informed care, criminal justice referrals, adolescents, veterans, pregnant women and Spanish-language services — Coverage is wider than most people assume. It is worth asking rather than ruling a programme out on the assumption it will not fit.

Three figures: 69.5% of facilities treat co-occurring disorders, 59.8% offer trauma-informed care, 19.5% run medical detox — Co-occurring capability is self-reported. Ask what it means concretely — which clinicians are on staff, and whether psychiatric medication can be prescribed and reviewed on site.

Bar chart comparing the share of facilities using a sliding fee scale across the nine largest US states, from 23% in North Carolina to 57% in Illinois — A national average is a poor guide to your own options. The same question — can I pay less than the sticker price? — gets a very different answer by state.

Bar chart comparing Medicaid acceptance among treatment facilities in the nine largest US states — Where the share is low, the reason is usually how the state runs its programme rather than reluctance among facilities.

What we count, and why it changes the advice

Every proportion on this site is our own count of the federal treatment directory — 10,233 facilities, deduplicated by name, street and ZIP. SAMHSA publishes the directory; it does not publish these figures, and they reframe a good deal of what gets written about this field.

Residential care is the scarce tier

85.4% of facilities offer outpatient treatment against 21.4% offering residential and 19.5% running medical detox. Advice that treats residential as the default is advice about the least available option.

The medication gap is regulatory

Buprenorphine is available at 59.2% of facilities and methadone at 13.7%, because methadone for opioid use disorder can only be dispensed through a certified programme — not because one works better.

Coverage is wider than the sticker price

83.4% accept Medicaid, 54.5% take state funding outside it, and 40% run a sliding fee scale. The last of those changes the number more often than anything else on the list.

Programmes for specific groups are common

42.7% run adolescent programmes, 39.2% serve veterans, 38% serve pregnant and postpartum women and 25% provide services in Spanish — wider than most people assume before asking.

What makes this site different

Primary sources, not summaries of summaries

Numbers come from the FDA label, the Code of Federal Regulations or the systematic review itself. That is what catches the drift — a Cochrane finding about a structured clinical intervention quoted as though it were about attending meetings, or a rule that stopped being enforced in 2025 described as current.

Scope conditions kept, not trimmed

When evidence applies only to alcohol, or only to a manualised programme, or only above a certain dose, these pages say so. Trimming that detail is how confident-sounding advice ends up not applying to the person reading it.

No incentive to send you anywhere

No placement fees, no referral commissions, no phone number of ours. That is why these pages can say plainly that outpatient care is the right answer for a great many people — a sentence that costs money to write in most of this sector.

The method is published

How we research and publish documents where the figures come from, what we refuse to put on the site, and an error our own counting caught. You can repeat the pull and check us.

Bar chart comparing the share of each state’s facilities offering residential treatment across the nine largest US states — Residential beds are unevenly distributed. In some states the search will realistically cross state lines.

Diagram of the step-down pathway through addiction treatment: detox, residential, partial hospitalisation, intensive outpatient, then outpatient and aftercare — Nobody needs every step. The ladder exists so that support can be reduced as stability improves, not so that everyone starts at the top.

Checklist of the six ASAM assessment dimensions: withdrawal risk, medical conditions, emotional and behavioural conditions, readiness to change, relapse potential, and recovery environment — This is the framework US programmes and insurers actually use. The sixth dimension — what home is like — is the one families most often underestimate.

Checklist of six questions to ask a treatment facility about network status, prior authorisation, all-in cost, medication availability, aftercare and accreditation — How plainly a programme answers these is itself information about how it operates.

Table showing when to call 911, 988 or the SAMHSA National Helpline for overdose, immediate danger, suicidal thoughts, severe distress and treatment questions — All three are free and staffed around the clock. 988 is the Suicide & Crisis Lifeline; the SAMHSA National Helpline is 1-800-662-4357.

What is on this site

Seven comparisons of the actual options

Levels of care, medications and housing, each laid out on what genuinely differs rather than on which sounds more serious. Start with the comparisons.

Five insurers, and the rules behind them

Aetna, Cigna, TRICARE, Humana and Ambetter, plus what the parity law requires and what stopped being enforced in 2025. Check your coverage.

Three guides for the hard parts

Getting someone to go, paying without insurance, and what the rules are once the doors close — including what federal leave law does and does not protect. Read the guides.

And the workings

Every figure traceable to a document you can open, with the method published rather than asserted, and a plain statement of who writes this and how it is funded.

If this is an emergency

Overdose, unconsciousness or a seizure

Call 911. Naloxone reverses opioid overdose and is available without a prescription at US pharmacies — worth keeping in the house where opioids are involved.

Suicidal thoughts or acute crisis

Call or text 988 for the Suicide & Crisis Lifeline — free, confidential and staffed around the clock.

Stopping drinking after heavy daily use

Alcohol withdrawal is one of the few that can be medically dangerous, and seizures can occur with no other symptoms present. What the timeline looks like and which factors rule out managing it at home.

Looking for treatment, not in danger

The SAMHSA National Helpline, 1-800-662-4357, gives referrals for your area at any hour. It is free, confidential, and reaches nobody connected to this site.

Sources we work from

How this page was made

Who wrote it:: the Treatment Compass editorial team — researchers and writers, not clinicians. No doctor has reviewed this page, and we do not claim otherwise. What that means in practice: we report what public clinical sources say and show you where to read them, rather than offering a clinical opinion of our own.
Checked against:: 6 primary sources listed above — federal agency material and published clinical criteria. Where a figure varies by state, plan or facility, we say so instead of publishing a number that looks authoritative and is not.
Original analysis:: the facility proportions on this page are our own count of SAMHSA’s public directory. The full method is documented — including what we count, what we deliberately do not publish, and an error the approach caught. You can repeat the pull and check the numbers.
Last reviewed:: August 25, 2026. This date changes when the content is actually re-checked, not automatically on every visit.
What this page is not:: a medical recommendation, a diagnosis, or a referral. Decisions about levels of care and medication belong with a clinician who knows your history. We do not operate facilities, take placement fees, or receive payment for sending anyone anywhere.