How to find a treatment program for opioid use disorder 

There are a number of treatment options for opioid misuse and opioid use disorder. The intensity of treatment depends on the severity of the problem. Once an opioid problem has been identified, referral to a substance use disorder treatment specialist can help to determine the right level of care (e.g., inpatient medical detoxification, medication, behavior therapy). Although treatment for opioid use disorder has not historically been available in primary care settings, efforts to increase access to treatment for opioid use disorder in primary care are underway, and some primary care offices offer treatment for opioid use disorder.

In the treatment of opioid use disorder, detoxification and “rehab” alone is not the most effective approach; in fact, outpatient approaches that include buprenorphine, methadone, or naltrexone are most effective and often much less expensive. Although research has not identified an optimal duration of care (i.e., how long someone should stay on medication), relapse is highly common after treatment is discontinued, and ongoing care is associated with the best outcomes.

Treatment programs vary in the quality of services they provide. Higher quality programs:

• Are certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and accredited by the Joint Commission or Commission on Accreditation of Rehabilitation Facilities
• Offer medication-assisted treatment (methadone, buprenorphine, naltrexone) in combination with counseling and behavioral therapies
• Offer family support
• If residential or inpatient level of care, offer detailed discharge planning for the transition back to the community

In addition, look for a program that is transparent and willing to answer any and all questions you have about the treatment process.

Both national and local agencies have databases of treatment programs that can be used to identify a local treatment program. There are some limitations to these databases (including challenges in keeping them up-to-date and lack of quality ratings), so vetting the agency using the criteria mentioned previously is recommended.

• In most states, naloxone (also known by the brand name Narcan) is available without a prescription.
• Naloxone/Narcan can be obtained from many pharmacies.
• In states requiring a prescription, primary care physicians can provide a prescription.
• The cost of naloxone varies but can be a significant concern. Many insurers will cover its costs, and some agencies can provide it for free (e.g., some towns heavily impacted by the opioid crisis have offerings for free naloxone kits).

In recent years, a disturbing new issue has emerged for the treatment of substance use disorders: predatory treatment programs. Predatory treatment programs are those that are oriented to maximizing billing of patients while minimizing effective treatment. Some characteristics of predatory treatment centers include offers to pay for travel and facilitate insurance coverage, the use of features unrelated to treatment to “sell” the program, use of multiple high-cost lab tests (as compared to standard substance use monitoring), little direct assessment of the patient, and lack of specialty in opioid use disorder treatment. Be especially careful with those that use aggressive marketing tactics or suggest suspiciously high “success rates.” It may be useful to ask specifically about which evidence-based practices they use and the basis on which they make those claims of success.