Heroin Rehab Cost: What Treatment Costs With & Without Insurance
Heroin use disorder has been dramatically reshaped by the fentanyl crisis. According to the Drug Enforcement Administration (DEA), the majority of heroin seized in the United States now contains fentanyl, making what was already a dangerous substance exponentially more lethal. Understanding treatment costs — and the life-saving role of medication-assisted treatment — is critical for families facing this crisis.
What Does Heroin Rehab Actually Cost?
The cost of inpatient heroin rehabilitation varies based on insurance coverage, program length, and whether medication-assisted treatment (MAT) is included. For heroin use disorder, MAT is the gold standard and is covered by all ACA-compliant insurance plans.
With Insurance (PPO)
With a PPO insurance plan, your estimated out-of-pocket costs for a 30-day inpatient heroin rehab program range from $7,500 to $22,000. This includes medical detox (5-7 days), residential treatment, and initiation of medication-assisted treatment with buprenorphine (Suboxone) or preparation for methadone maintenance.
PPO plans offer the greatest flexibility in facility selection and typically have the most comprehensive coverage for both treatment and ongoing MAT medications. HMO and EPO plans may require in-network facilities and have more restrictive medication formularies.
Without Insurance
Without insurance, the same 30-day program costs between $18,000 and $55,000. Medical detox alone — essential for managing heroin withdrawal safely and initiating MAT — adds $2,000 to $6,500. Ongoing MAT medication costs $350 to $600 per month without insurance coverage.
Here’s what many people don’t realize: under the Affordable Care Act, all marketplace plans must cover substance use disorder treatment, including medication-assisted treatment. A PPO plan with comprehensive addiction coverage typically costs $400-$750 monthly — a fraction of the cost of paying out of pocket, and it can save your life.
The Cost of Heroin Detox
Heroin withdrawal is not medically dangerous in the way alcohol or benzodiazepine withdrawal can be, but it is extremely uncomfortable and difficult to complete without medical support. More importantly, medically supervised detox allows for immediate initiation of medication-assisted treatment, which dramatically improves long-term outcomes.
| Detox Component | Without Insurance | With PPO Insurance |
|---|---|---|
| Medical monitoring (24/7) | $300 – $900/day | $200 – $700/day |
| Typical duration | 5 – 7 days | 5 – 7 days |
| Total detox cost | $2,000 – $6,500 | $1,200 – $4,900 |
| Comfort medications | Included | Included |
| MAT initiation (buprenorphine) | Included | Included |
Most evidence-based detox programs for heroin use disorder initiate buprenorphine (Suboxone) during the detox phase using the Clinical Opiate Withdrawal Scale (COWS) to determine appropriate timing. This allows for a much more comfortable withdrawal and immediate transition to maintenance MAT.
Medication-Assisted Treatment for Heroin Use Disorder
MAT is the most effective treatment for heroin use disorder. Research consistently shows that individuals on MAT have significantly lower overdose risk, better treatment retention, and higher rates of sustained recovery compared to abstinence-only treatment approaches.
Buprenorphine (Suboxone, Sublocade) is a partial opioid agonist that reduces cravings and withdrawal symptoms. It can be initiated during detox and continued long-term. Available as a daily sublingual film/tablet or monthly injection (Sublocade).
Methadone is a full opioid agonist dispensed daily through certified opioid treatment programs (OTPs). Highly effective for severe heroin use disorder and individuals who have not succeeded with buprenorphine. Requires daily clinic visits initially, with take-home doses earned over time.
Naltrexone (Vivitrol) is an opioid antagonist available as a monthly injection. Blocks the effects of opioids but requires complete detox (7-10 days) before initiation, making it less commonly used than buprenorphine for heroin use disorder.
| MAT Medication | Monthly Cost (Uninsured) | Monthly Cost (Insured) | Typical Duration |
|---|---|---|---|
| Buprenorphine (generic) | $150 – $350 | $10 – $75 | 12-24 months minimum |
| Buprenorphine (Suboxone brand) | $400 – $600 | $25 – $150 | 12-24 months minimum |
| Sublocade (monthly injection) | $1,600 – $1,800 | $50 – $300 | 6+ months |
| Methadone (OTP clinic) | $300 – $500 | $50 – $200 | Indefinite (often years) |
| Naltrexone (Vivitrol injection) | $1,200 – $1,500 | $50 – $250 | 12+ months |
With insurance, most MAT medications have minimal copays under the Mental Health Parity and Addiction Equity Act (MHPAEA), which requires insurers to cover addiction treatment medications at the same level as medications for other medical conditions.
Choosing the Right Program Length
| Duration | Best For | Insured Cost Range | Uninsured Cost Range |
|---|---|---|---|
| 30 days | Short-duration heroin use, strong support system, MAT continuation planned | $7,500 – $22,000 | $18,000 – $55,000 |
| 60 days | Moderate to severe heroin use, co-occurring mental health conditions | $15,000 – $44,000 | $36,000 – $110,000 |
| 90 days | Long-term heroin use, fentanyl contamination, multiple prior treatments | $22,500 – $66,000 | $54,000 – $165,000 |
The National Institute on Drug Abuse (NIDA) recommends a minimum of 90 days for heroin use disorder, with ongoing MAT for 12-24 months minimum. Many individuals remain on MAT indefinitely, which is supported by research showing long-term MAT dramatically reduces overdose risk.
The Heroin-Fentanyl Crisis
According to the DEA’s 2024 National Drug Threat Assessment, fentanyl and fentanyl analogs are now found in the majority of heroin samples across the United States. This has made heroin use exponentially more dangerous:
- Fentanyl is 50-100 times more potent than heroin
- Overdose can occur in seconds to minutes
- Naloxone (Narcan) may require multiple doses
- Many individuals believe they’re using heroin when they’re actually using fentanyl
This contamination crisis makes treatment even more urgent. MAT with buprenorphine or methadone provides life-saving protection by eliminating the need to use street drugs of unknown potency and composition.
Don’t Have Insurance?
If you’re currently uninsured, getting covered is often the most cost-effective and life-saving decision. All ACA-compliant plans cover heroin use disorder treatment as an essential health benefit, including medical detox, residential treatment, and medication-assisted treatment. A licensed insurance specialist can help you understand your options, check for qualifying life events, and find plans that cover the treatment you need.
Sources
- National Institute on Drug Abuse (NIDA). “Heroin Research Report.” 2024.
- Drug Enforcement Administration (DEA). “National Drug Threat Assessment.” 2024.
- Centers for Disease Control and Prevention (CDC). “Drug Overdose Deaths.” 2024.
- Substance Abuse and Mental Health Services Administration (SAMHSA). “Medication-Assisted Treatment (MAT).” 2024.
- National Institute on Drug Abuse (NIDA). “Medications to Treat Opioid Use Disorder.” 2024.
You May Qualify for Coverage That Pays for heroin rehab
Under the Affordable Care Act, all marketplace health insurance plans must cover addiction treatment as an essential health benefit. Monthly premiums for a PPO plan that covers rehab typically range from $350 to $700 — a fraction of the cost of paying out of pocket.
A licensed insurance specialist can help you find the right plan, check for qualifying life events, and get covered — often within days.
Talk to an Insurance Specialist — Free & ConfidentialFrequently Asked Questions
How much does heroin rehab cost without insurance?
Without insurance, a 30-day inpatient heroin treatment program typically costs between $18,000 and $55,000. Medical detox adds $2,000 to $6,500 for the initial 5-7 day withdrawal management period. Medication-assisted treatment (MAT) with buprenorphine or methadone adds $350-$600 monthly. Payment plans and sliding-scale options are available at many facilities.
Does insurance cover heroin rehab?
Yes. Under the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, all marketplace health insurance plans must cover heroin use disorder treatment as an essential health benefit. This includes medical detox, medication-assisted treatment (MAT), residential programs, and outpatient care. PPO plans typically offer the broadest facility access and medication coverage.
How long does heroin detox take?
Heroin detox typically lasts 5 to 7 days for acute withdrawal symptoms. Physical withdrawal symptoms usually begin 6-12 hours after last use and peak around 1-3 days. Post-acute withdrawal symptoms (PAWS) — including mood disturbances, sleep issues, and cravings — can persist for weeks or months, which is why medication-assisted treatment (MAT) is strongly recommended.
What is the best treatment for heroin addiction?
The most effective treatment for heroin use disorder combines medication-assisted treatment (MAT) with behavioral therapy. Research from NIDA shows that MAT reduces overdose deaths by 50% and dramatically improves treatment retention. Buprenorphine (Suboxone) and methadone are the most commonly prescribed medications for heroin use disorder, both proven effective in reducing cravings and preventing relapse.
Is heroin often mixed with fentanyl?
Yes. According to the DEA, the vast majority of heroin seized in the United States now contains fentanyl or fentanyl analogs. This has made heroin use dramatically more dangerous, contributing to the spike in overdose deaths. Many individuals who believe they're using heroin are actually using fentanyl-contaminated heroin or pure fentanyl, which is 50-100 times more potent than heroin.
How long should heroin rehab last?
Research from the National Institute on Drug Abuse (NIDA) indicates that 90 days or longer of treatment produces significantly better outcomes for heroin use disorder. Most evidence-based programs recommend at least 90 days of residential or intensive outpatient treatment combined with ongoing MAT for 12-24 months minimum. Many individuals benefit from staying on MAT indefinitely.