Prescription Drug Rehab Cost: What Treatment Costs With & Without Insurance

Prescription drug use disorder affects millions of Americans, spanning multiple drug classes: opioid painkillers (OxyContin, Percocet, Vicodin), benzodiazepines (Xanax, Valium, Klonopin), stimulants (Adderall, Ritalin), and sedatives. According to SAMHSA’s National Survey on Drug Use and Health, approximately 8.7 million Americans misused prescription drugs in 2023. Understanding treatment costs is complicated by the fact that different prescription drugs require dramatically different treatment approaches.

What Does Prescription Drug Rehab Actually Cost?

The cost of prescription drug rehabilitation varies significantly based on which drug class is involved, as detox protocols, length of stay, and treatment approaches differ substantially between opioid painkillers, benzodiazepines, and stimulants.

With Insurance (PPO)

With a PPO insurance plan, your estimated out-of-pocket costs for a 30-day inpatient prescription drug rehab program range from $6,000 to $20,000. This includes medical detox (duration varies by drug class), residential treatment, and evidence-based therapies appropriate to the specific drug class — including medication-assisted treatment for prescription opioids.

PPO plans offer the most flexibility in facility selection and typically have the most comprehensive coverage for medication-assisted treatment and extended detox protocols. HMO and EPO plans may require in-network facilities.

Without Insurance

Without insurance, the same 30-day program costs between $15,000 and $50,000. Medical detox costs vary dramatically by drug class: opioid painkillers ($2,000-$6,500), benzodiazepines ($3,500-$12,000 due to longer taper requirements), stimulants ($1,200-$3,500), and sedatives (similar to benzodiazepines).

Under the Affordable Care Act, all marketplace health insurance plans must cover prescription drug use disorder treatment as an essential health benefit. A PPO plan with comprehensive addiction coverage typically costs $400-$750 monthly.

Prescription Drug Detox Costs by Drug Class

Different prescription drug classes require different detox approaches and durations:

Opioid Painkillers (OxyContin, Percocet, Vicodin, Hydrocodone, Oxycodone)

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
MAT initiation (buprenorphine)	Included	Included

Prescription opioid detox follows the same protocols as heroin detox, with immediate transition to medication-assisted treatment recommended.

Benzodiazepines (Xanax, Valium, Klonopin, Ativan)

Detox Component	Without Insurance	With PPO Insurance
Medical monitoring (24/7)	$350 – $850/day	$250 – $650/day
Typical duration	10 – 14+ days	10 – 14+ days
Total detox cost	$3,500 – $12,000+	$2,500 – $9,100+
Gradual taper protocol	Included	Included

Benzodiazepine detox requires gradual tapering over weeks or months. Abrupt cessation can cause life-threatening seizures.

Stimulants (Adderall, Ritalin, Vyvanse)

Detox Component	Without Insurance	With PPO Insurance
Medical monitoring & support	$250 – $500/day	$150 – $350/day
Typical duration	3 – 7 days	3 – 7 days
Total detox cost	$1,200 – $3,500	$600 – $2,450
Symptom management	Included	Included

Stimulant withdrawal is not medically dangerous but produces fatigue, depression, and increased appetite.

Prescription Opioid Treatment

For prescription opioid use disorder (painkillers), medication-assisted treatment (MAT) is the gold standard. Many individuals transition from prescription painkillers to heroin or fentanyl due to cost and availability — MAT prevents this progression.

MAT for Prescription Opioids

Buprenorphine (Suboxone, Sublocade) is most commonly used for prescription opioid use disorder. Initiated during detox and continued long-term (12-24 months minimum).

Methadone is highly effective but requires daily clinic visits to certified opioid treatment programs.

Naltrexone (Vivitrol) blocks opioid effects but requires complete detox (7-10 days opioid-free) before initiation.

MAT Medication	Monthly Cost (Uninsured)	Monthly Cost (Insured)
Buprenorphine (generic)	$150 – $350	$10 – $75
Buprenorphine (Suboxone brand)	$400 – $600	$25 – $150
Sublocade (monthly injection)	$1,600 – $1,800	$50 – $300
Methadone (OTP)	$300 – $500	$50 – $200
Naltrexone (Vivitrol injection)	$1,200 – $1,500	$50 – $250

Research from NIDA shows that MAT reduces overdose deaths by 50% for opioid use disorder.

Benzodiazepine Treatment

Benzodiazepine treatment focuses on safe medical detox with gradual tapering, followed by treatment of underlying anxiety disorders with non-addictive medications (SSRIs, SNRIs, buspirone) and cognitive behavioral therapy.

Key considerations:

• Gradual taper over weeks or months
• 24/7 medical monitoring during detox
• Seizure precautions essential
• Alternative anxiety treatments must be initiated
• Extended residential treatment often necessary

Stimulant Treatment

For prescription stimulants (Adderall, Ritalin, Vyvanse), treatment focuses on behavioral therapies, as there are currently no FDA-approved medications for stimulant use disorder.

Key considerations:

• Assessment for underlying ADHD (legitimate medical need vs. misuse)
• Alternative ADHD treatments if appropriate (non-stimulants like Strattera)
• Contingency management and CBT
• Addressing underlying causes of stimulant misuse (academic pressure, workplace demands)

Choosing the Right Program Length

Duration	Best For	Insured Cost Range	Uninsured Cost Range
30 days	Single-class dependence, first treatment, strong support	$6,000 – $20,000	$15,000 – $50,000
60 days	Long-term use, multiple substances, co-occurring conditions	$12,000 – $40,000	$30,000 – $100,000
90+ days	Severe dependence, multiple failed treatments, complex medical history	$18,000 – $60,000+	$45,000 – $150,000+

Length requirements vary by drug class: benzodiazepine dependence often requires longer residential stays due to extended detox protocols.

Prescription Drug Misuse Statistics

According to SAMHSA, CDC, and NIDA:

• 8.7 million Americans misused prescription drugs in 2023 (SAMHSA)
• 3.5 million misused prescription opioid painkillers
• 4.8 million misused benzodiazepines
• 1.6 million misused prescription stimulants
• 16,706 deaths involving prescription opioids in 2023 (CDC)
• 12,499 deaths involving benzodiazepines in 2023 (CDC)

The prescription opioid epidemic peaked around 2010-2012 but remains significant. Many individuals who began with prescription painkillers later transitioned to heroin and fentanyl when prescriptions became unavailable.

The Prescription-to-Addiction Pipeline

Most prescription drug use disorders begin with legitimate medical prescriptions:

For Opioid Painkillers:

1. Prescription for acute pain (surgery, injury, dental work)
2. Extended prescribing beyond acute phase
3. Tolerance development (medication becomes less effective)
4. Physical dependence (withdrawal when dose is missed)
5. Use disorder (continued use despite negative consequences)
6. Potential transition to heroin/fentanyl when prescription access ends

For Benzodiazepines:

1. Prescription for anxiety or insomnia
2. Long-term prescribing (despite guidelines recommending 2-4 weeks maximum)
3. Tolerance and dose escalation
4. Physical dependence (severe withdrawal if stopped)
5. Use disorder (unable to function without medication)

For Stimulants:

1. Prescription for ADHD (or obtained from others)
2. Academic or work performance pressure
3. Dose escalation for increased effect
4. Tolerance development
5. Use disorder (continued use beyond medical need)

Poly-Substance Use

Many individuals with prescription drug use disorder use multiple substances:

• Opioids + Benzodiazepines — Extremely dangerous combination, dramatically increases overdose risk
• Stimulants + Alcohol — Common pattern for managing stimulant effects
• Benzodiazepines + Alcohol — Cross-tolerance and similar withdrawal risks

Poly-substance use requires integrated treatment addressing all substances simultaneously.

Co-Occurring Mental Health Conditions

Prescription drug use disorder frequently co-occurs with mental health conditions:

• Chronic pain conditions (for opioid painkillers)
• Anxiety disorders (for benzodiazepines)
• ADHD (for stimulants — determining legitimate need vs. misuse is complex)
• Depression (across all drug classes)
• PTSD (self-medication with multiple drug classes)

Quality treatment programs provide integrated care for both the prescription drug use disorder and underlying medical or psychiatric conditions.

Don’t Have Insurance?

If you’re currently uninsured and dependent on prescription drugs, getting coverage is essential. Attempting to stop benzodiazepines or opioids without medical supervision can be dangerous. All ACA-compliant plans cover prescription drug use disorder treatment, including medical detox, MAT for opioids, and behavioral therapies. A licensed insurance specialist can help you find coverage that includes the specific treatment your situation requires.

Sources

• Substance Abuse and Mental Health Services Administration (SAMHSA). National Survey on Drug Use and Health. 2024.
• Centers for Disease Control and Prevention (CDC). “Drug Overdose Deaths.” 2024.
• National Institute on Drug Abuse (NIDA). “Prescription Opioids and Heroin Research Report.” 2024.
• National Institute on Drug Abuse (NIDA). “Prescription CNS Depressants DrugFacts.” 2024.
• National Institute on Drug Abuse (NIDA). “Prescription Stimulants DrugFacts.” 2024.
• Substance Abuse and Mental Health Services Administration (SAMHSA). “Medications to Treat Opioid Use Disorder.” 2024.