Addiction Treatment: Steps, Types, Medication and Costs
In This Article
Substance use disorders (SUDs) are problematic but treatable. However, many people ignore treatment because they haven’t hit rock bottom or think they don’t have a problem. Only 1 in 10 people receive treatment for alcohol or drug addiction.1
Who Needs Addiction Treatment?
You may need treatment if you:2, 3, 4
- Have strong alcohol or drug cravings
- Have a chronic disease or mental health conditions caused or aggravated by substance abuse
- Increase the amount of addictive substances to get the desired effects
- Experience withdrawal symptoms if you suddenly stop taking alcohol or drugs
- Try to quit repeatedly but with no success
Consult a medical professional for a formal diagnosis. You can also check the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) for the 11 criteria used for diagnosing substance use disorder.2, 3, 5
What is the First Step to Addiction Recovery?
People who experience adverse effects due to substance abuse must recognize that they might have an addiction. Acknowledging the problem is the first step of the recovery process.
Once people accept the problem, they can seek treatment. The treatment type or types will depend on their unique needs and situation.
No one substance use treatment is the best for everyone. What may work for you may not work for another person. Some people may even need a combination of treatment options.
Types of Treatment Programs
Treatments for alcohol and drug addiction include:
Inpatient treatment takes place in residential facilities offering 24-hour care. This is usually for people with severe addiction or those requiring constant supervision.
Inpatient treatment is categorized based on the type of treatment facility:6, 7, 8
- Therapeutic communities (TC): People seeking treatment reside in a treatment facility for 6 to 12 months. The staff and community serve as key factors in changing the residents' attitudes, beliefs, and behaviors regarding substance abuse.
- Shorter-term residential treatment: This involves shorter but more intensive treatment. It focuses on detoxification followed by a modified 12-step program.
- Recovery housing: This involves supervised, short-term housing that helps people adapt to a substance-free, independent life.
Outpatient treatment doesn’t require 24-hour care or living in the facility. It suits people with less severe addictions, jobs, and a supportive home environment.
The two types of outpatient treatments are:6, 7, 9
- Low- or moderate-intensity outpatient program: Provides up to 9 hours of weekly sessions for adults (up to 6 hours for adolescents).
- Intensive outpatient program: Provides 9 hours or more of weekly sessions for adults (6 hours or more for adolescents).
Partial Hospitalization Program (PHP)
PHP suits people with unstable medical and psychiatric conditions. It requires 20 hours or more of weekly sessions. All treatment services take place at the facility. Unlike inpatient rehab, people can go home after treatment.7
Medication-assisted treatment (MAT) involves medications that can help manage withdrawal symptoms, reduce cravings, or prevent relapse.
Medications approved by the U.S. Food and Drug Administration (FDA) include:6
- Naltrexone: Blocks opioids from binding to opioid receptors in the brain. It can also decrease alcohol cravings and prevent relapse.
- Methadone and buprenorphine: Opioid agonists that bind to the same receptors as other opioids. They can relieve opioid cravings and suppress withdrawal symptoms.
- Bupropion and varenicline: Prevents relapse of nicotine addiction.
- Acamprosate: May reduce symptoms of long-lasting alcohol withdrawal.
- Disulfiram: Disrupts alcohol metabolism. This can cause nausea and other adverse effects should the person drink alcohol.
Types of Behavioral Therapies Used in Addiction Treatment
Behavioral therapies can be done one-on-one, as a group, or with family, depending on the person’s needs. They’re usually intensive at the start of treatment. Sessions gradually reduce over time as the person’s symptoms improve.
Behavioral therapies include:
- Cognitive behavioral therapy (CBT): It helps people recognize situations where they’re likely to use drugs or alcohol. It also helps develop coping skills to enhance a person’s self-control.6, 8
- Dialectical behavior therapy (DBT): This focuses on developing skills in four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.10
- Contingency management (CM): This approach uses rewards (like vouchers or prizes) to encourage positive changes in behavior. It’s also called “motivational incentives.”6, 8
- Motivational interviewing: It helps people resolve their uncertainty in getting treatment and maximizes their willingness to change their behaviors.6, 8
- Multidimensional family therapy (MDFT): This is designed for adolescents with drug abuse problems. It looks at drug-related influences (like peers, family members, or the community) and improves family functions.6, 8
- Rational emotive behavior therapy (REBT): It helps people identify negative feelings and thought patterns and replace them with healthier beliefs.11
- Holistic therapy: Involves non-medicinal recovery methods that are combined with conventional treatments. Examples include yoga, meditation, acupuncture, massage, nutrition, and exercise.12
Addiction Treatment Aftercare
Some treatment facilities have aftercare programs. Examples include sober-living arrangements, follow-up therapy and counseling, and alumni support groups.
Many treatment programs encourage people to participate in support groups during and after treatment. These groups serve as a source of motivation, support, and information.6
Popular support groups include:
- Alcoholics Anonymous (AA)
- Narcotics Anonymous (NA)
- SMART Recovery (Self-Management and Recovery Training)
Does Insurance Cover Addiction Treatment?
Yes, health insurance is a common payment method for addiction treatment. It can cover all or part of the costs depending on the plan.
Contact your insurance provider for more information. Some facilities can also provide details about your status and whether they’re part of your insurance network.
You can also check government-funded plans. Medicare is usually for older people, while Medicaid caters to people with disabilities and adults below a certain income level.13, 14
There’s also the Affordable Care Act (ACA). Health insurance providers with marketplace plans must comply with the ACA. Policies can cover 60 to 90% of the treatment costs depending on the selected plan.
Call to find out how much your insurance will cover
- Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health.” U.S. Department of Health and Human Services. November 2016.
- American Psychiatric Association Publishing. “Substance-Related and Addictive Disorders.” DSM Library (Psychiatry Online).
- Hasin, Deborah S et al. “DSM-5 criteria for substance use disorders: recommendations and rationale.” The American journal of psychiatry vol. 170,8 : 834-51.
- “The Science of Drug Use and Addiction: The Basics.” National Institute on Drug Abuse (NIDA).
- American Psychiatric Association. “Diagnostic and statistical manual of mental disorders (5th ed.).” American Psychiatric Publishing. 2013.
- “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse (NIDA). January 2018.
- “Overview of Substance Use Disorder (SUD) Care Clinical Guidelines: A Resource for States Developing SUD Delivery System Reforms.” Medicaid Innovation Accelerator Program (IAP). April 2017.
- “Treatment Approaches for Drug Addiction.” National Institute on Drug Abuse (NIDA). January 2019.
- “Treatment Settings.” National Institute on Drug Abuse (NIDA). January 2014.
- “Dialectical Behavior Therapy.” Psychology Today. Accessed February 11, 2022.
- Turner, Martin J. “Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes.” Frontiers in psychology vol. 7 1423. September 20, 2016.
- Jorgensen, Donna. “A Holistic Approach to Substance Abuse Treatment and the Mind, Body, Spirit, Connection.” The University of Wisconsin-Platteville. 2015.
- “What's Medicare?” Medicare.gov. Accessed January 23, 2022.
- “Who is eligible for Medicaid?” HHS.gov. Accessed January 23, 2022.