Updated on February 6, 2024
5 min read

Does Insurance Cover Opioid Rehab?

Does Insurance Cover Opioid Rehab?

Health insurance can cover some or all of treatment program costs. The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires all health insurers to cover substance abuse and mental health treatment.

Coverage will depend on:

  • The type of rehab center you attend
  • Whether you need substance abuse and/or mental health treatment
  • Length of stay
  • Your deductible, maximum out-of-pocket, and coinsurance costs

Opioid Addiction Treatment Options

Opioid addiction is a chronic, yet treatable condition.10 Treatment for OUD combines several therapeutic interventions, including:

Inpatient Treatment

Inpatient treatment is the recommended addiction treatment for people with severe OUD. Inpatient treatment centers have nursing and counseling staff on hand 24/7. They provide professional support for people undergoing medical detox and severe withdrawal symptoms. People with OUD will reside at the facility for the duration of treatment. 

After someone undergoes medical detox, they will continue to attend group and behavioral therapy as part of treatment. Through therapy, they will address mental health concerns that might relate to their substance abuse. Inpatient treatment centers provide a monitored environment that can help someone stabilize and achieve sobriety.

Outpatient Treatment

Outpatient treatment centers provide follow-up care for people leaving inpatient treatment. They also provide addiction treatment for people with mild to moderate OUD. 

Outpatient opioid treatment programs provide services, including:

  • Support groups
  • Twelve-step meetings
  • Individual behavioral therapy
  • Cognitive behavioral therapy (CBT)
  • Treatment for co-occurring disorders such as post-traumatic stress disorder (PTSD) and depression

Outpatient treatment classes are held a minimum of 9 hours per week in 3-hour sessions. People can return home or to a sober living facility after their classes. 

Outpatient treatment outcomes have been shown to be as effective as inpatient treatment.11 They offer flexibility to people seeking addiction treatment who do not want to reside in an inpatient facility. 

Medication Assisted Treatment (MAT)

Medication-assisted treatment (MAT) is an essential component of OUD recovery. Medications can help prevent opioid overdose, reduce opioid cravings by blocking opioid receptors, and minimize withdrawal symptoms. Common MAT medications for OUD include:


Buprenorphine is often the first medication prescribed for opioid addiction treatment. It is only available by prescription from physicians with special certifications. Buprenorphine is available in a sublingual tablet that is placed under the tongue. It is a partial opioid antagonist that reduces cravings and withdrawal symptoms. 

Buprenorphine produces mild euphoric effects in small doses. These effects are less pronounced than in medications like methadone. Buprenorphine has been shown to increase safety in case of opioid overdose.12


Naltrexone is an opioid antagonist medication. It binds to the opioid receptors in the brain and blocks the feelings of euphoria associated with opioid use. It can be taken as a daily pill or injected by a treatment provider once a month. 

Naltrexone reduces cravings and helps sustain sobriety.13 


Methadone is also an opioid antagonist. It blocks the effects of opioids and minimizes withdrawal symptoms. Methadone also helps reduce opioid cravings.14 

Methadone should only be taken as prescribed by a physician. It is taken in an outpatient setting, known as a methadone clinic, under close medical supervision. When a treatment provider determines someone is stabilized, they can take methadone at home without medical monitoring. 


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Signs and Symptoms of Opioid Addiction

There are various signs that might indicate someone has an opioid or opiate addiction. These include:

  • Increased opioid tolerance
  • Withdrawal symptoms after stopping opioid use
  • Continued use despite legal problems
  • Continued use despite deteriorating physical health
  • Taking opioids without a prescription
  • Opioid dependence
  • Using more opioids than intended
  • Opioid binges

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Signs and Symptoms of Opioid Withdrawal

Opioid withdrawal symptoms can occur after someone suddenly stops using opioids. Opioid withdrawal is dangerous and sometimes life-threatening. 

Opioid withdrawal symptoms include:

  • Anxiety
  • Agitation
  • Sweating
  • Increased heart rate
  • Stomach cramps
  • Increased opioid cravings
  • Diarrhea
  • Dilated pupils
  • Panic attacks
  • High blood pressure
  • Flu-like symptoms such as sneezing and body aches8
  • Uncontrollable shaking
  • Goosebumps
  • Insomnia

Opioid Overprescription and Opioid Addiction

Opioid addiction is also known as opioid use disorder (OUD). OUD occurs as a result of increased tolerance and dependence to prescription opioids.2 Regular use can lead to opioid addiction in as little as 4 to 8 weeks.3

Opioid addiction occurs due to a repeated, high release of the chemical dopamine in the brain. Dopamine creates feelings that can become addictive. These include:

  • Pleasure
  • Euphoria
  • Body high
  • Mental relaxation

These feelings activate the reward system in the brain, which makes some people want to seek out prescription opioids or opiates.4 Ingestion of external opioids also suppresses the naturally-occurring endogenous opioids (enkephalins and endorphins) and their functions. 

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Opioid Overprescription and the Current Opioid Epidemic 

The feelings of pleasure opioids and opiates create are what make them highly addictive. 

People with OUD will try to obtain prescription opioids even if they aren’t currently suffering from pain. This is because stopping opioid use can lead to withdrawal. Opioid withdrawal is a painful and sometimes life-threatening condition.

Although the overprescription of opioids seems to be decreasing, the Centers for Disease Control and Prevention (CDC) reported 142,816,781 opioids were prescribed in 2020 alone.7

What are Opioids?

Opioids are a class of drugs derived from the poppy plant. Opioids are commonly prescribed to treat acute or chronic pain. Both opioids and opiates are derived from the opium poppy plant. Although they might be used interchangeably, there is a difference between the two.1

Opiates are natural derivatives of the opium poppy plant that include illicit substances, like:

  • Heroin
  • Morphine
  • Opium
  • Codeine

Opioids are synthetic, human-made substances that include prescription painkillers, like:

  • Fentanyl 
  • Oxycontin
  • Vicodin
  • Hydromorphone
  • Hydrocodone

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Updated on February 6, 2024
14 sources cited
Updated on February 6, 2024
  1. Opiates or opioids - what's the difference? (n.d.) Alcohol and Drug Policy Commission: Opiates or Opioids - What's the difference? : State of Oregon. 
  2. Butanis, B. (2018, April 30). What are opioids?
  3. Sharma, B., Bruner, A., Barnett, G., & Fishman, M. (2016, July). Opioid use disorders.
  4. Kosten, T. R., & George, T. P. (2002, July). The neurobiology of opioid dependence: Implications for treatment. 
  5. Shah, M. (2021, October 11). Opioid withdrawal.
  6. Hirsch, R. . The opioid epidemic: It's time to place blame where it belongs
  7. U.S. opioid dispensing rate maps. (2021, November 10). 
  8. Dydyk, A. M. (2022, January 28). Opioid use disorder
  9. Panda, P. K., Sharawat, I. K., & Choudhury, S. . New-onset seizures due to heroin addiction.
  10. Recovery is possible: Treatment for opioid addiction. (2021, September 2). 
  11. McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014, June 1). Substance Abuse Intensive Outpatient Programs: Assessing the evidence.
  12. Buprenorphine. (n.d.). SAMHSA. 
  13. Naltrexone. (n.d.). SAMHSA.
  14. Methadone. (n.d.). SAMHSA.

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