Residential rehab for opiate addiction

SAMHSA says residential care usually lasts a few weeks to a few months. Programs for more serious conditions can last a year or more.

Many programs advertise a set number of days. No fixed number is right for everyone. What matters is that the stay is long enough for you to get stable and that there is a solid plan for afterwards.

If you still have opioids in your system when you arrive, the first days are usually spent on supervised withdrawal or starting a medication.

Every program is different, but most days follow a fixed timetable. A typical one includes:

• a set wake-up time, meals together and medication rounds
• group sessions, which make up most of the day
• a one-to-one session with your counselor, often weekly
• classes on cravings, triggers and coping skills
• some exercise, chores and free time
• a mutual-help or peer support meeting in the evening

Phone use and visits are often limited at first. Ask about the rules beforehand, including whether family can take part in sessions.

Many people do well without ever living at a program. A residential stay tends to help most when:

• home is not a safe place to stop, because others there use or you have no stable housing
• outpatient care has not been enough, even with medication
• you have other mental health or medical conditions that need close attention
• you use several substances, such as opioids with alcohol or benzodiazepines

Leaving work and family for weeks is a big step. Our page on taking leave for treatment explains job-protected leave.

SAMHSA publishes a short checklist of signs of quality treatment. These questions follow it.

• Do you offer medication for opioid use disorder, and can I stay on mine? A quality program provides FDA-approved medication. Be cautious of any program that makes you stop buprenorphine or methadone to be admitted. Leaving a residential stay with no medication and a lowered tolerance raises the risk of overdose.
• Are the program and its staff licensed and accredited? Ask by whom, and check with your state.
• Which therapies do you use? Look for named, evidence-based ones such as cognitive behavioral therapy.
• Can my family be involved if I want that?
• What happens when I leave? Expect a written plan with booked appointments. See aftercare for what a good one covers.
• What will I owe, in writing? Ask what your insurance pays and what happens to the bill if you leave early.

Most programs are honest. Some are not, and they target frightened families. Be careful if you notice any of these:

• Someone offers free flights, cash, gifts or free rent to get you to enrol. Paying or taking kickbacks for patient referrals is a federal crime.
• A hotline will not say who owns it or keeps steering you to a single facility.
• You are promised a cure or quoted a success rate with no source.
• You are pushed to commit today, or to travel far from home before anyone has assessed you.
• Staff will not give a price, a license number or the names of clinical staff.
• Medication is banned, or described as “not real recovery”.
• They seem more interested in your insurance details than in your health.

Our directory lists licensed programs drawn from public records, and no listing is paid for. You can find treatment in your state and read how we choose listings.