There is no single right way to recover from substance use disorder. Everyone is different, and a person may need different levels of support at different times in their recovery. Here are some of the common options:

Detox

In detox, staff provides supervised medical care as a person goes through withdrawal immediately after ceasing to use drugs or alcohol. Because withdrawal can produce dangerous physical, emotional, and mental effects, this process should often be carried out with expert help. This is especially true for anyone with a history of delirium tremens (DTs) who stops drinking, as DTs can be fatal.

Many people assume that any treatment or rehab provider will also offer detox care, but that is not true. Because of the serious health concerns in detox, many treatment centers do not cover it. It is more likely to be referred to a hospital. 

Detox without insurance coverage:

As with most medical care in America, detox can be pricey.

• Many hospitals offer payment plans, which can break the cost down into smaller, more manageable payments made over a period of time.
• Some hospitals and detox centers offer assistance for people below a certain income level (often called “Eligibility Services” or “Financial Assistance”). Hospitals often don’t volunteer this information, so be sure to ask about it. You may have to provide evidence of your income to be considered.

Treatment facilities

Inpatient treatment

Inpatient treatment is what most of us think of when we hear about rehab. It is also known as residential treatment. With inpatient care, you will check into a facility and stay there throughout the day and night. This level of care provides the most supervision, and is therefore best for people who are at high risk or who need medical monitoring. Inpatient rehab is a controlled environment with round-the-clock care. People can stay in inpatient programs anywhere from 28 days to 6 months.

Inpatient treatment may include 1:1 therapy, group counseling, medication, physical activities, nutritional counseling, and educational sessions.

Outpatient treatment

Outpatient treatment means that people come for treatment and then go home when their session or appointment is finished. At many facilities, people begin with “intensive outpatient,” or IOP, and then shift to a lower intensity. During IOP, most people will attend multiple-hour sessions several days a week. After IOP is completed (sometimes with a graduation ceremony), continuing treatment includes shorter and less frequent sessions. These sessions can include group therapy, education about addiction, teaching coping strategies, and more.

Treatment sessions at outpatient treatment facilities often last three to six months, but may continue for a year. Outpatient treatment is usually much less expensive than inpatient treatment, so if you don’t need full-time care, it is a good choice. 

Treatment facilities without insurance coverage:

• Many facilities offer payment assistance or sliding scales. Talk to the facilities you’re interested in to see if they do.
• Look for state-funded treatment facilities. The Substance Abuse and Mental Health Services Administration (SAMHSA)’s Treatment Locator has filters than can help you find treatment centers that are funded by the government. These often have waitlists, but it is worth checking!
• Some individual counties offer grants to cover treatment for county residents who have no insurance. Try looking at your county’s Public Health department’s webpage, or search for “Substance Abuse Block Grant” and your county.

Medication-assisted treatment

Addiction treatment has come a long way since the 1930s, and there now are FDA-approved medications to treat opioid and alcohol use disorders. Medication-assisted treatment (MAT) can reduce cravings, lessen the risk of relapse, and help to stabilize recovery. For opioid use disorder, in particular, MAT is considered the gold standard of treatment.

Not every doctor can or will prescribe medications for substance use disorder. To get medical treatment for addiction:

• Look for addiction medicine doctors (the American Board of Addiction Medicine has a directory and SAMSHA has a Buprenorphine Treatment Locator) or psychiatrists near you.
• If you have a primary care doctor, they may be able to give you a referral even if they are not able to prescribe MAT.
• Telehealth makes medication-assisted treatment (MAT) accessible to people who otherwise wouldn’t be able to find it. Workit Health offers MAT in many states, and other telehealth companies are arising, as well.

MAT without insurance coverage:

• Most doctors accept self-pay (in fact, more than those who accept insurance). They may have payment plans to space out the fees for your appointments.
• Many facilities offer payment assistance or sliding scales. Talk to the facilities you’re interested in to see if they do.
• Prescription discount plans and pharmaceutical manufacturer coupons often provide discounts on the medications themselves. See our guides to affording Suboxone and naltrexone without insurance coverage for more information. 

Recovery coaching

Although dealing with substance use disorder can be incredibly isolating, you are most definitely not alone. Many people have dealt with the same things you’re going through, and many of them have become recovery coaches. Peer recovery coaches are people who are themselves in recovery and who professionally work with others toward their recovery goals. Peer recovery coaching is a growing field, and research shows that it provides beneficial support for people with addiction.

To find a recovery coach:

• Check your state’s local peer recovery coaching options through an internet search.
• Recovery community centers may act as a local hub to help you find a coach. For example, Connecticut offers a telephone recovery support network. In Austin, Texas, Communities for Recovery allows people to find a coach in their area. Check to see if there is a recovery community center in your area.

Peer recovery coaching without insurance coverage:

• Peer recovery coaching is often an affordable option, and most coaching services accept self-pay.  
• There are some free peer coaching options, like the ones available through Families Against Narcotics.
• Some organizations offer sliding scale fees for peer coaching, based on income. A resource like FindHelp.org might help you locate a peer recovery coach with a sliding scale.  

Meditation

You’ve probably heard that meditation can help with stress, but did you know it can also help with addiction? Studies have shown that meditation can boost brain chemicals and reduce relapse. Meditation can help us gain awareness of our triggers and cravings without acting upon them.

Meditation without insurance coverage:

• Refuge Recovery, a support group based on Buddhist beliefs and meditation, offers a basic set of meditations for free on their website. You can also attend meditation meetings in person.

Meditations are more accessible than ever, thanks to technology:

• Search for meditations on YouTube (Workit Health offers some meditation videos on our channel)
• Try a meditation app like Insight Timer, which offers a lot of free options.
• Apps like Headspace and Calm can also be good resources, but require a paid account after a limited free trial.

Mutual support groups

Mutual support groups are an option for affordable, accessible support. 12-step groups like Alcoholics Anonymous and Narcotics Anonymous have no membership fees and are supported by voluntary contributions but their members. Most towns and cities have regular meetings, and there are Zoom meetings available for anyone to attend regardless of location.

If 12-step meetings don’t appeal to you, there are many alternatives:

• Smart Recovery: self-help addiction recovery
• Women for Sobriety: recovery empowering women to overcome addiction
• Refuge Recovery: Buddhist-inspired mindfulness recovery
• Celebrate Recovery: Christ-centered 12-step recovery (meetings are usually affiliated with an individual church)
• LifeRing: abstinence-based, secular recovery
• Moderation Management: focused on reducing the harm caused by alcohol