Compare Your Treatment Options

Most people arrive at addiction treatment facing a choice they have no framework for making: which level of care, which medication, which kind of housing. These comparisons lay out what actually differs — hours, cost, who each option suits — so the decision rests on something concrete.

Every comparison

Sober Living Home vs Halfway House
Sober living is privately paid and open-ended; a halfway house is usually assigned with a fixed time limit. Cost, rules, testing and stay length compared.
Monthly cost to you: $500–$1,200vsOften $0
PHP vs IOP
PHP runs 20-30 structured hours a week and IOP runs 9-19. The real question is whether home can hold the other 148 hours.
Structured hours per week: 20–30vs9–19
Detox vs Rehab
Detox manages withdrawal safely, rehab treats why the drug or alcohol use started, and detox alone rarely holds. What each stage does, how long, and when.
Typical length: 3–7 daysvs30–90 days
Suboxone vs Methadone
Methadone needs a certified programme with daily visits at first, while Suboxone comes from a regular prescriber. Both work, so access usually decides it.
Where you get it: PharmacyvsCertified programme
Inpatient vs Outpatient
Inpatient means living on site with round-the-clock support, outpatient fits around your life, and what decides is the hours treatment does not cover.
Supervised hours per week: 168vs9–19
12-Step vs Non-12-Step
AA and NA are available almost everywhere and cost nothing, while SMART, LifeRing and Refuge are secular alternatives. What differs and how to choose.
Cost to attend: Free or donationvsFree or low cost
Naltrexone (Vivitrol) vs Suboxone (buprenorphine)
Naltrexone blocks opioids and needs 7-10 days clean first, while Suboxone starts in withdrawal. That gap decides most cases.
Wait before first dose: 7–10 daysvsNone — start in withdrawal
Vivitrol (naltrexone) vs Suboxone (buprenorphine)
A monthly gluteal injection against a daily film. What the shot involves, why it cannot be undone, and the one situation that reverses the whole comparison.
Dosing interval: Every 4 weeksvsDaily
Brixadi vs Sublocade
Weekly or monthly, fridge or shelf, one injection site or four. The practical differences between the two buprenorphine depots, and the 2025 label change.
Injection interval: 7 or 28 daysvs28 days

Bar chart of how many US treatment facilities offer each level of care: outpatient 85.4%, residential 21.4%, medical detox 19.5%, hospital inpatient 5.9% — Outpatient care is nearly universal; residential and detox are the scarce tiers. That scarcity is part of why they cost what they do and why waits exist.

Bar chart of payment types accepted by US addiction treatment facilities: cash 91.6%, private insurance 80.7%, Medicaid 83.4%, Medicare 55.2%, state-financed 54.5%, military 49.6%, sliding scale 40.0%, payment assistance 22.5% — Accepting your insurer is not the same as your plan covering the level of care you need. The two questions have to be asked separately.

Which comparison answers your question

These pages sit at three different decision points, and reading them in the wrong order wastes time. If nobody has been assessed yet, the level-of-care comparisons come first: inpatient against outpatient, then PHP against IOP if outpatient is the direction. If withdrawal is the immediate issue, detox against rehab is the one to read, because the two are routinely confused and only one of them addresses why use continued. If opioids are involved and medication is on the table, the medication comparisons matter more than the setting. And if the question is what happens after treatment ends, the housing and mutual-aid pages are the ones that deal with it.

Start here if nothing has been decided

Inpatient against outpatient is the fork almost everyone reaches first, and the honest answer turns on two things rather than severity in the abstract: whether withdrawal needs supervision, and whether home is where use happens. Only 21.4% of US facilities offer residential care at all, against 85.4% offering outpatient, so availability shapes this more than most pages admit.

Start here if stopping is the immediate problem

Detox against rehab covers the distinction that gets missed most often, including which withdrawals are medically dangerous and which are merely unpleasant. Medical detox is offered by 19.5% of facilities, which makes it one of the scarcer services and one worth arranging before it is needed rather than during.

Start here if medication is the question

Suboxone against methadone and naltrexone against Suboxone both come down to access rather than to which medicine is stronger. Buprenorphine is available at 59.2% of facilities and methadone at 13.7% \u2014 a gap that is regulatory rather than clinical, and the single fact that decides most real cases.

Start here if treatment is ending

Sober living against a halfway house deals with where someone goes next, including the third model most comparisons omit entirely. Twelve-step against the secular alternatives covers what runs alongside treatment rather than instead of it \u2014 both are free, and the evidence for the twelve-step side is stronger than most people on either side expect.

Bar chart of medication for opioid use disorder availability: buprenorphine at 59.2% of facilities, methadone at 13.7%, certified opioid treatment programmes at 12.8% — The four-to-one gap between buprenorphine and methadone availability is a regulatory fact, not a clinical judgement about which works better.

Bar chart of dedicated programming reported by US treatment facilities for older adults, women, men, trauma-informed care, criminal justice referrals, adolescents, veterans, pregnant women and Spanish-language services — Coverage is wider than most people assume. It is worth asking rather than ruling a programme out on the assumption it will not fit.

Three figures: 69.5% of facilities treat co-occurring disorders, 59.8% offer trauma-informed care, 19.5% run medical detox — Co-occurring capability is self-reported. Ask what it means concretely, which clinicians are on staff, and whether psychiatric medication can be prescribed and reviewed on site.

What these comparisons are not

They are not a ranking of facilities, and we do not maintain one. They do not tell you which option is right for a particular person, because that depends on a history none of these pages has access to. And they are not a substitute for an assessment \u2014 what they are for is arriving at that assessment knowing which questions decide the answer, so the conversation starts further along than it otherwise would.

Every figure quoted across these pages is our own count of the federal treatment directory; the method is documented in full, including what the numbers cannot tell you.

Bar chart comparing the share of facilities using a sliding fee scale across the nine largest US states, from 23% in North Carolina to 57% in Illinois — A national average is a poor guide to your own options. The same question — can I pay less than the sticker price? — gets a very different answer by state.

Bar chart comparing Medicaid acceptance among treatment facilities in the nine largest US states — Where the share is low, the reason is usually how the state runs its programme rather than reluctance among facilities.

Bar chart comparing the share of each state’s facilities offering residential treatment across the nine largest US states — Residential beds are unevenly distributed. In some states the search will realistically cross state lines.

Diagram of the step-down pathway through addiction treatment: detox, residential, partial hospitalisation, intensive outpatient, then outpatient and aftercare — Nobody needs every step. The ladder exists so that support can be reduced as stability improves, not so that everyone starts at the top.

How the choice is actually made

None of these decisions is made on severity in the abstract. US programmes and insurers both work from the ASAM criteria, six dimensions that an assessment scores together: withdrawal risk, medical conditions, emotional and behavioural conditions, readiness to change, relapse potential, and the recovery environment. Reading the comparisons with those six in mind is the difference between choosing an option and being able to argue for one.

The two dimensions that decide most cases

Withdrawal risk sets the floor: if stopping is medically dangerous \u2014 which for alcohol and benzodiazepines it can be \u2014 the level of care has to be one where that is managed. The recovery environment sets the ceiling: where home is where use happens, an option that sends someone back there each evening is asking the hardest thing in the least supportive place. Most disagreements about level of care are really disagreements about one of these two.

Why the plan gets a vote

A clinical recommendation is not an authorisation. Insurers review the same ASAM documentation and can approve a lower level than the one recommended, which is one of the most common outcomes and an appealable one. Knowing which party is blocking \u2014 the assessment, the plan, or availability \u2014 changes entirely what you do next.

Movement between levels is normal

Nobody needs every step, and stepping down as stability improves is how the system is designed to work rather than a sign that something went wrong. Stepping up is equally ordinary. The comparisons below describe adjacent rungs of one ladder, not a set of rival products.

Checklist of the six ASAM assessment dimensions: withdrawal risk, medical conditions, emotional and behavioural conditions, readiness to change, relapse potential, and recovery environment — This is the framework US programmes and insurers actually use. The sixth dimension — what home is like — is the one families most often underestimate.

Checklist of six questions to ask a treatment facility about network status, prior authorisation, all-in cost, medication availability, aftercare and accreditation — How plainly a programme answers these is itself information about how it operates.

Table showing when to call 911, 988 or the SAMHSA National Helpline for overdose, immediate danger, suicidal thoughts, severe distress and treatment questions — All three are free and staffed around the clock. 988 is the Suicide & Crisis Lifeline; the SAMHSA National Helpline is 1-800-662-4357.

What is actually available, nationally

Comparisons are written as though every option were equally reachable, and they are not. These are our own counts of the federal directory, and they change what the choice means in practice more than any argument about which option is better.

Levels of care are not evenly distributed

Outpatient treatment is offered by 85.4% of facilities, residential care by 21.4%, and medical detox by 19.5%. The scarcity of the last two is why waits exist there and why an outpatient start is frequently available in the week a residential bed is still being arranged.

Medication availability is a regulatory fact

Buprenorphine is available at 59.2% of facilities and methadone at 13.7%, because methadone for opioid use disorder can only be dispensed through a certified programme. Naltrexone sits at 53.1%, with the extended-release injection at 47.5% — far more common than most people assume.

Payment routes are wider than the sticker price

83.4% of facilities accept Medicaid, 54.5% take state funding outside it, and 40% operate a sliding fee scale. The last of those is almost never volunteered on a first call, which is why asking for it by name changes the number so often.

Before you call anyone

Two things make every subsequent conversation shorter. Know which level of care is being discussed, because coverage, cost and waiting times all differ by level rather than by facility. And know what your plan is, because network status applies per service and not per centre — a programme can be in network for outpatient care and out of network for residential. Everything else can be worked out on the call; those two cannot.

Questions people ask before choosing

Which comparison should I read first?

If nothing has been decided, start with inpatient against outpatient. If stopping safely is the immediate problem, start with detox against rehab. If opioids and medication are involved, the medication comparisons decide more than the setting does.

Do you recommend specific treatment centres?

No. We publish national and state-level figures from the federal treatment directory and explain how the options differ. We do not rank facilities, take placement fees or receive payment for referrals — which is why these pages can say that outpatient care is the right answer for a great many people.

Where do the percentages on these pages come from?

They are our own count of SAMHSA’s public treatment locator, deduplicated by name, street and ZIP. SAMHSA publishes the directory but not these proportions; the full method is documented, including what the numbers cannot tell you.

Sources used across these pages

How this page was made

Who wrote it:: the Westbrook Recovery editorial team : researchers and writers, not clinicians. No doctor has reviewed this page, and we do not claim otherwise. What that means in practice: we report what public clinical sources say and show you where to read them, rather than offering a clinical opinion of our own.
Checked against:: 6 primary sources listed above: federal agency material and published clinical criteria. Where a figure varies by state, plan or facility, we say so instead of publishing a number that looks authoritative and is not.
Original analysis:: the facility proportions on this page are our own count of SAMHSA’s public directory. The full method is documented , including what we count, what we deliberately do not publish, and an error the approach caught. You can repeat the pull and check the numbers.
Last reviewed:: August 25, 2026. This date changes when the content is actually re-checked, not automatically on every visit.
What this page is not:: a medical recommendation, a diagnosis, or a referral. Decisions about levels of care and medication belong with a clinician who knows your history. We do not operate facilities, take placement fees, or receive payment for sending anyone anywhere.

Also see our practical guides and insurance coverage explainers.

Information, not medical advice. If you are in crisis, call or text 988 in the US, or reach the SAMHSA National Helpline at 1-800-662-4357 — free, confidential, 24/7.