Substance Guide

Opioids (Prescription Painkillers) Addiction Treatment & Costs

Comprehensive information on prescription opioid use disorder, treatment options, withdrawal risks, and what you can expect to pay for care.

SAMHSA Helpline: 1-800-662-4357

Overview

Prescription opioid addiction affects millions of Americans and is a primary driver of the opioid crisis. Medications like oxycodone (OxyContin), hydrocodone (Vicodin), codeine, and fentanyl patches are prescribed for pain but carry significant addiction potential. Many people who develop opioid use disorder started with a legitimate prescription. The transition from prescribed use to misuse to addiction can happen gradually.

Signs of Opioid Addiction

Opioid use disorder can develop even when medications are used as prescribed. Watch for these warning signs:

Taking more medication than prescribed
Doctor shopping or obtaining from multiple sources
Crushing, snorting, or injecting pills
Running out of prescriptions early
Mood swings and irritability
Social withdrawal
Continued use despite negative consequences
Neglecting work and relationships

Withdrawal Risks

Opioid withdrawal is extremely uncomfortable but typically not life-threatening. Symptoms include muscle pain, restlessness, anxiety, insomnia, sweating, nausea, vomiting, and diarrhea. Medical detox with tapering or MAT medications is strongly recommended to manage symptoms and prevent relapse.

Treatment Approaches

Evidence-based opioid treatment combines medication with behavioral therapies for the best outcomes:

Medication-assisted treatment (MAT): buprenorphine, methadone, naltrexone
Gradual medically supervised taper
Inpatient rehabilitation
Outpatient and intensive outpatient programs
Cognitive behavioral therapy
Pain management alternatives for chronic pain patients
Support groups and peer recovery

Treatment Details at a Glance

Detox Duration

Acute withdrawal: 5–10 days. Post-acute symptoms may persist for weeks to months

Relapse Rate

40–60% relapse rate; long-term MAT produces best outcomes

Cost of Treatment

Detox: $1,000–$4,000. Inpatient rehab: $6,000–$30,000 for 30 days. MAT: $200–$600/month. Outpatient: $1,000–$10,000 for 3 months.

Cost Breakdown

Detox: $1,000–$4,000. Inpatient rehab: $6,000–$30,000 for 30 days. MAT: $200–$600/month. Outpatient: $1,000–$10,000 for 3 months.

Medication-assisted treatment (MAT) is often the most cost-effective long-term option. Many insurance plans, including Medicaid, cover MAT medications and counseling. Check with your insurer or a treatment center about financial assistance.

Ready to Get Help?

The SAMHSA National Helpline provides free, confidential, 24/7 treatment referrals and information for individuals and families facing prescription opioid addiction.

Call 1-800-662-4357

Free & Confidential — 24/7/365 — English & Español

What to Look for in an Opioid Treatment Facility

Opioid addiction treatment has evolved significantly in recent years, with medication-assisted treatment (MAT) emerging as the gold standard of care. When evaluating treatment facilities, it is essential to look beyond surface-level amenities and focus on the clinical capabilities that drive successful recovery outcomes.

MAT Availability and Expertise

Medication-assisted treatment using buprenorphine (Suboxone), methadone, or naltrexone (Vivitrol) is the most evidence-based approach to opioid addiction. Look for facilities with certified prescribers who have extensive experience managing these medications. The best programs do not simply prescribe and forget; they integrate MAT with individual counseling, group therapy, and regular medication adjustments based on patient progress. Be wary of programs that refuse to offer MAT or discourage its use, as this contradicts established medical evidence.

Fentanyl Testing and Awareness

The prevalence of fentanyl in the illicit drug supply has fundamentally changed opioid addiction treatment. Quality facilities conduct comprehensive drug testing that specifically screens for fentanyl and its analogs, as many patients may not know they have been exposed. Programs should have protocols specifically designed for fentanyl-involved cases, which often require longer stabilization periods and more careful medication titration due to fentanyl's extreme potency.

Harm Reduction Approach

Modern opioid treatment facilities embrace harm reduction principles, recognizing that recovery is not always linear. This means providing naloxone (Narcan) training and distribution to patients and families, offering non-judgmental support when setbacks occur, and maintaining a philosophy that keeps patients engaged in treatment even if they experience a lapse. Facilities that discharge patients for relapse are using an outdated approach that increases the risk of fatal overdose.

Long-Term Medication Management

Many people with opioid use disorder benefit from months or even years of medication treatment. The best facilities plan for long-term care from the beginning, establishing connections with outpatient MAT providers, primary care physicians comfortable managing buprenorphine, or opioid treatment programs (OTPs) that offer methadone. Avoid programs that pressure patients to taper off medications quickly, as premature discontinuation is a leading cause of relapse and overdose death.

Overdose Prevention Training

Every opioid treatment program should provide overdose prevention education and naloxone (Narcan) training to all patients and their families before discharge. This training should cover how to recognize the signs of an overdose, how to administer naloxone, and when to call emergency services. Many states now allow naloxone to be dispensed without a prescription, and quality programs ensure patients leave with a naloxone kit and the knowledge to use it.

Frequently Asked Questions About Opioid Treatment

Q: What is medication-assisted treatment (MAT) for opioids?

Medication-assisted treatment combines FDA-approved medications (buprenorphine, methadone, or naltrexone) with behavioral counseling and support services. MAT is considered the gold standard for opioid use disorder treatment because it reduces cravings, prevents withdrawal symptoms, and blocks the euphoric effects of opioids. Research shows MAT cuts the risk of overdose death by more than 50% and significantly improves treatment retention rates compared to abstinence-only approaches.

Q: What is the difference between Suboxone and methadone?

Suboxone (buprenorphine/naloxone) is a partial opioid agonist that can be prescribed by certified physicians in office-based settings, offering more flexibility and privacy. Methadone is a full opioid agonist that must be dispensed daily at a licensed opioid treatment program (OTP), though take-home doses may be earned over time. Methadone is often preferred for severe addictions or when Suboxone has not been effective. Both are highly effective when used as directed, and the choice depends on individual circumstances, treatment history, and accessibility.

Q: How long does opioid rehab take?

Initial residential treatment typically lasts 30 to 90 days, but opioid recovery is a long-term process. Many patients continue outpatient therapy and MAT for one to two years or longer. The National Institute on Drug Abuse recommends that MAT continue for a minimum of one year, and some individuals benefit from indefinite medication maintenance. Rushing through treatment or tapering medications prematurely is associated with higher relapse rates.

Q: Are there specific concerns with fentanyl addiction?

Fentanyl presents unique treatment challenges due to its extreme potency (50 to 100 times stronger than morphine). Patients addicted to fentanyl often require higher initial doses of buprenorphine or methadone to manage withdrawal, and the induction process must be handled more carefully to avoid precipitated withdrawal. Fentanyl also accumulates in body fat, meaning withdrawal symptoms can be prolonged and unpredictable. Treatment facilities experienced with fentanyl cases will have protocols specifically designed for these complications.

Q: How much does opioid addiction treatment cost?

Outpatient MAT programs typically cost $200 to $600 per month, including medication and counseling. Residential inpatient programs range from $6,000 to $30,000 for 30 days. Methadone maintenance through an OTP averages $126 per week. Many insurance plans, including Medicaid and Medicare, are required to cover opioid addiction treatment. Free and low-cost options are available through federally qualified health centers and state-funded programs. The long-term cost of untreated opioid addiction, including emergency care and lost productivity, far exceeds treatment costs.

Q: How can I get naloxone (Narcan)?

Naloxone is available without a prescription at most pharmacies nationwide. Many states offer free naloxone through health departments, harm reduction organizations, and community distribution programs. Narcan nasal spray is the most common formulation and requires no medical training to administer. If you or someone you know uses opioids, having naloxone readily accessible can be the difference between life and death in an overdose situation. Most treatment programs will also provide naloxone kits at discharge.

Q: What does opioid withdrawal feel like, and how long does it last?

Opioid withdrawal symptoms include severe muscle aches, nausea, vomiting, diarrhea, insomnia, anxiety, and intense drug cravings. For short-acting opioids like heroin, symptoms typically begin 8 to 12 hours after the last dose and peak at 36 to 72 hours. For longer-acting opioids or fentanyl, the timeline can be extended and less predictable. While opioid withdrawal is rarely life-threatening, the extreme discomfort drives many people back to use, which is why medically managed withdrawal with MAT is strongly recommended.

Q: Can I work while receiving opioid addiction treatment?

Yes, many people maintain employment while receiving opioid treatment, particularly through outpatient MAT programs. Buprenorphine and methadone stabilize brain chemistry without producing a high, allowing patients to function normally at work. Intensive outpatient programs (IOPs) often schedule sessions in the evening to accommodate work schedules. Federal law protects employees receiving MAT from discrimination, and your treatment records are protected by strict confidentiality regulations.

Q: How common is relapse with opioid addiction?

Relapse rates for opioid addiction range from 40% to 60%, similar to other chronic conditions like diabetes and hypertension. Relapse is most common in the first 6 to 12 months after treatment, particularly among those who discontinue MAT prematurely. Relapse should be viewed as a signal that treatment needs adjustment, not as a failure. The most dangerous period is immediately after a relapse, when reduced tolerance dramatically increases the risk of fatal overdose. This is why ongoing MAT and naloxone availability are so critical.

Q: What are the long-term recovery rates for opioid addiction?

Long-term outcomes improve substantially with sustained treatment. Patients who remain on MAT for at least two years have recovery rates of 50% or higher, compared to less than 10% for those who receive only short-term detox without follow-up care. Recovery success increases with time: each year in stable treatment improves the odds of lasting recovery. Factors that predict better outcomes include strong social support, stable housing, continued therapy participation, and sustained engagement with MAT when indicated.

Explore Treatment Types

Learn more about the different levels of care available for opioid addiction treatment: