Rehabilitation services are essential to addressing substance use disorders in the United States.
According to the 2022 National Survey on Drug Use and Health (NSDUH), an estimated 54.6 million people aged 12 and older needed treatment for a substance use disorder, but only 26% of those received any help.
Despite the availability of 17,808 substance abuse facilities nationwide, a staggering number of individuals in the United States continue to struggle without receiving the necessary care.
To understand the gap in this treatment disparity, we created the Rehab Index to evaluate and compare each state’s performance based on critical factors that contribute to the effectiveness and accessibility of substance use rehabilitation services.
This Index aims to shed light for policymakers and healthcare providers on where states are excelling and where they are falling short in providing essential rehab services. As the demand for effective rehab continues to grow, this serves as a valuable resource in improving substance use related services by determining the areas that need improvement.
Which States Provide the Best Access to Addiction Treatment?
Ranking the best state for rehabilitation services involves evaluating various factors such as rehab costs, the number of facilities, State Mental Health Agency (SMHA) expenditure, availability of buprenorphine practitioners, facilities reporting participation with insurers, rates of user reporting illicit drug dependence or abuse, drug overdose deaths, and the number of people needing but not receiving substance use treatment.
Here are the top five US states excelling in providing comprehensive and effective rehabilitation services:
#1 Maine
Total Score: 69.4/100
Maine ranks first in providing rehabilitation services, achieving an impressive total score of 69.4 out of 100. The state ranks second in the US for having the most number of rehab facilities per capita, with 14.15 rehab facilities per 100,000 people. Additionally, the residential rehab cost in Maine is $56,108, which is lower than the US average of $57,006.
Why Maine Ranks High:
- Maine earned a score of 98 for its numerous rehab facilities, ensuring access to all needing treatment.
- The state scored 93.9 for having a sufficient number of Buprenorphine practitioners (34.14 per 100,000 people), ensuring high availability of medication-assisted treatment.
- Maine scored 83.7 for having lower residential rehab costs compared to other US states, highlighting affordability.
- The state scored 81.6 in SMHA expenditure, investing $291 per capita in healthcare and mental health services.
- Maine received a relatively high score of 65.3 for having 75% of rehab facilities accepting insurance, improving access to treatment.
- The state scored 91.8 for its low number of individuals needing but not receiving substance use treatment, highlighting effective substance use treatment service delivery.
#2 Alaska
Total Score: 68.2/100
Alaska ranks second for its excellent rehab services, getting a score of 68.2 out of 100. Nationwide, it boasts the highest number of rehab facilities (14.31 per 100,000 people) and is the second cheapest state for rehab costs, with an average residential cost of $52,030.
Why Alaska Ranks High:
- Aside from being the state with the highest number of rehab facilities, Alaska also scored a perfect score of 100 for the number of Buprenorphine practitioners, with 38.03 per 100,000 people, ensuring comprehensive treatment availability.
- Alaska got a score of 98 in terms of cost for being one of the states with the cheapest rehab treatment prices, costing below the national average, making treatment more affordable and accessible for individuals needing help.
- Alaska scored 77.6 in SMHA expenditure, investing $280 per capita in healthcare and mental health, reflecting a strong commitment to supporting its residents.
- The state received a score of 73.5 for its substantial number of rehab facilities with insurer participation, with 77% of facilities accepting insurance, ensuring accessibility for those with coverage.
#3 Wyoming
Total Score: 66.7/100
Wyoming ranks third in the nation for its outstanding rehab services, achieving a total score of 66.7 out of 100. Even though the cost of rehab in Wyoming is the most expensive across the US, averaging $65,975 for residential care, the state excels in other areas. Notably, Wyoming ranks second in the US for having the highest percentage of rehab facilities accepting insurance (86.33%).
Why Wyoming Ranks High:
- Wyoming scored 95.9 for its low percentage of individuals struggling with illicit drug dependence or abuse, which stands at 11.18%, emphasizing the success of its prevention programs in reducing substance abuse.
- The state received a strong score of 95.9 for its efficient service delivery, with only 69.4% of individuals needing but not receiving substance use treatment.
- Wyoming earned a score of 79.6 for maintaining a low drug overdose death rate of 21.9 per 100,000 people, highlighting its effective harm reduction strategies.
- The state achieved a high score of 98 for its abundant number of rehab facilities accepting insurance, making treatment more accessible with 86.33% of facilities participating.
- Wyoming received a score of 87.8 for its good count of rehab facilities, ensuring ample treatment availability with 10.32 facilities per 100,000 people.
#4 Idaho
Total Score: 64.3/100
Idaho secures the fourth position in the rehab index ranking, achieving a total score of 64.3 out of 100. Idaho’s rehab services stand out for their affordability. It is the cheapest state for residential rehab, with an average cost of $42,195.
Why Idaho Ranks High:
- Idaho scored a perfect score of 100 for topping the list for the most affordable rehab residential cost across the US, making treatment financially accessible.
- The state achieved a score of 83.7 for its low drug overdose death rate at 20.7 per 100,000 people, reflecting effective harm reduction and prevention measures.
- Idaho got a 75.5 score for having a relatively low number of individuals reporting illicit drug dependence or abuse, at 12.60%, showing successful prevention efforts.
- The state received a score of 67.3 for its substantial number of rehab facilities accepting insurance, with 75.67% of facilities participating, contributing to the overall affordability and accessibility of treatment.
#5 South Dakota
Total Score: 62.8/100
South Dakota completes the top five with a balanced performance across several key metrics, achieving a total score of 62.8 out of 100. This state also ranks first in the US for having the lowest drug overdose death rate, at 11.3 per capita. This impressive statistic underscores the state’s effective prevention measures and robust public health initiatives.
Why South Dakota Ranks High:
- South Dakota achieved a perfect score of 100 for having the lowest drug overdose death rate nationwide, emphasizing the positive impact of accessible addiction treatment.
- The state received a high score of 91.8 for its low rate of individuals reporting illicit drug use, with only 11.77% of the population, indicating the effectiveness of its preventive programs and initiatives in curbing drug abuse.
- South Dakota scored 83.7 for its residential rehab cost, making treatment more affordable with an average cost of $56,108.
- The state got a strong 79.6 score for having a low number of individuals who need but do not receive substance use treatment, showing efficient substance abuse treatment service delivery.
- South Dakota earned a score of 69.4 for the number of rehab facilities available, ensuring ample treatment options with 6.37 facilities accessible per 100,000 people.
Which States Have the Most Room for Improvement in Addiction Treatment?
#50 Nevada
Total Score: 24.8/100
Nevada ranks 50th on the rehab index with a total score of 24.8 out of 100, highlighting significant opportunities for growth and development in rehabilitation services. It also ranked fourth among the states for the most expensive residential rehab cost, averaging $62,530. Despite the high cost, more than half of the facilities in Nevada accept insurance (67.33%), making rehab services more accessible for many residents.
Why Nevada Ranks Low:
- Nevada scored 14.3 in terms of the rehab facility count, with only 3.43 facilities per 100,000 people, indicating limited treatment options.
- The state got a score of 30.6 for Buprenorphine practitioners’ availability, providing 11.61 practitioners per 100,000 people, reflecting a need for more medication-assisted treatment providers.
- The state got a low score of 10.2 for its high rate of individuals reporting illicit drug dependence or abuse, at 22.32%, depicting a pervasive substance abuse problem that requires comprehensive intervention and support systems to address effectively.
- The state got a score of 24.5 for having a significant number of people needing but not receiving substance use treatment, affecting 78.21% of those in need, underscoring a critical gap in service delivery that prevents many from accessing necessary care.
- The state scored 10.2 in SMHA expenditures, investing only $42 per capita, indicating a potential area for increased investment in mental health and rehabilitation services.
- Nevada got a low score of 6.1 for rehab costs, making rehab treatment less accessible.
- Nevada scored 40.8 for the number of facilities with insurers’ participation, with 67.33% of facilities accepting insurance, indicating a relatively higher count but still calling for more facilities to accept insurance to improve accessibility.
#49 South Carolina
Total Score: 31.1/100
South Carolina ranks 49th in the rehab index with a total score of 31.1 out of 100. Despite the overall ranking, rehab facilities in South Carolina like Lantana Recovery are committed to bridging the gap and providing top-notch addiction treatment services to residents of South Carolina. More than half of the rehab facilities in South Carolina accept insurance (60.67%), providing some level of accessibility to treatment. Additionally, only 12.13% (scoring 81.6) of individuals are reported to have illicit drug dependence or abuse, indicating a relatively lower prevalence of substance abuse issues in the state.
Why South Carolina Ranks Low:
- The state has a low score of 2 for the number of rehab facilities, with only 2.35 facilities per 100,000 people, indicating very limited substance use treatment access for its residents.
- South Carolina got a 26.5 score for its expensive average rehab treatment cost of $57,774, making access to care more challenging.
- The state scored 26.5 in terms of facilities reporting participation with insurers, suggesting the need to increase the number of facilities accepting insurance for better accessibility.
- South Carolina earned a score of 28.6 on SMHA, or $94 per capita, prompting the need to increase investment in substance use treatment services.
- The state got a score of 18.4 for its high rate of drug overdose death, recording 44.7 deaths per 100,000 people, underscoring the urgency of providing immediate addiction treatment access to prevent further loss of life.
- South Carolina received a score of 36.7 for the availability of Buprenorphine practitioners, providing 12 practitioners per 100,000 people, implying a need for more providers.
- The state scored 46.9 because of the 74.74% individuals needing but not receiving treatment, underscoring a critical shortfall in available treatment services.
#48 Florida
Total Score: 32.2/100
Florida ranks 48th in the rehab index with a total score of 32.2 out of 100. Only 13.27% (scoring 67.3) of individuals in the state report illicit drug dependence or abuse, indicating a comparatively lower rate of substance abuse issues within the state. Additionally, Florida’s residential rehab costs (scoring 59.2) are below the national average, amounting to $56,640.
Why Florida Ranks Low:
- Florida got a score of 10.2 for its low rehab facilities count, with only 3.20 facilities per 100,000 people, indicating limited treatment availability.
- The state received a low score of 6.1 for the number of facilities accepting insurance, with only 52.33% of facilities participating, accentuating the need for more facilities to provide access for insured residents seeking treatment.
- Florida scored 8.2 for needing to increase investment in state mental health services, with only $41 per capita, reflecting underfunded support systems.
- The state attained a score of 49 for having a relatively high count of individuals needing but not receiving treatment, at 74.59%, underlining deficiencies in treatment availability and accessibility.
- Florida got a 40.8 score for its high number of drug overdose deaths recorded, at 35.2 per 100,000 people, signaling a significant public health issue that demands immediate attention to improve access to addiction treatment.
- The state received a score of 24.5 for its low count of Buprenorphine practitioners available, providing only 11.18 practitioners per 100,000 people, reflecting limited availability of medication-assisted treatment.
#47 Louisiana
Total Score: 34.5/100
Louisiana ranks 47th in the nationwide rehab index with a total score of 34.5 out of 100. The state has a high SMHA expenditure, investing $200 per capita in mental health services, which has achieved a score of 71.4. This significant investment underscores Louisiana’s commitment to improving mental health care and providing robust support for those in need.
Why Louisiana Ranks Low:
- Louisiana scored 6.1 for its high drug overdose death rate, recording 54.5 deaths per 100,000 people, underscoring a severe public health crisis that calls for improved addiction treatment availability.
- The state scored 12.2 for its low rehab count, offering only 3.38 facilities per 100,000 people, indicating the need to build more facilities to accommodate all individuals needing treatment.
- Louisiana got a score of 22.4 in terms of facilities reporting participation with insurers, with only 60.67% accepting insurance,necessitating an increase in the number of facilities accepting insurance to ensure more residents can afford and access treatment.
- The state earned a 34.7 score for its almost the US average rehab cost, at $56,822, suggesting room for cost improvement.
- Louisiana got a score of 46.9 for Buprenorphine practitioners count, providing 13.33 practitioners per 100,000 people, yet still indicating a shortage of providers.
- The state scored 42.9 for the 75.71% individuals needing but not receiving treatment, highlighting the urgent need to improve access to and availability of treatment services.
- Louisiana scored 53.1 for having a relatively low rate of 15.07% reporting illicit drug dependence or abuse, reflecting effective prevention measures but still emphasizing the need to reduce this number further to improve the state’s overall rehab performance.
#46 Illinois
Total Score: 35.8/100
Illinois ranks 46th in the nationwide rehab index with a total score of 35.8 out of 100. The state’s residential rehab cost is $56,666, which is slightly below the national average. Additionally, Illinois has a relatively low drug overdose death rate of 30 per 100,000 people, with a corresponding score of 63.3, showcasing its interventions’ effectiveness in combating drug-related issues.
Why Illinois Ranks Low:
- Illinois scored 0 for having the highest count of individuals needing but not receiving treatment nationwide, at 82.42%, highlighting the urgent need to expand treatment services and improve access to care.
- The state received a 53.1 score on rehab cost affordability, which is slightly below the national average.
- Illinois scored 42.9 for the number of available rehab facilities, offering only 5.67 facilities per 100,000 people, emphasizing the need for more treatment centers to adequately meet the demand for rehabilitation services and ensure timely access to care.
- Illinois scored 20.4 for SMHA expenditure, investing only $67 per capita, indicating the need to increase investment in rehab services.
- The state got a score of 38.8 for the rate of available Buprenorphine practitioners, with 12.05 practitioners per 100,000 people, suggesting a need for more providers to ensure adequate access to medication-assisted treatment for individuals struggling with opioid dependence.
- The state scored 22.4 for the number of facilities accepting insurance, with only 60.67% participating, underscoring the need to increase this number to be able to provide help and access for those with coverage.
- Illinois got a 30.6 score for its 17.24% of individuals reporting illicit drug dependence or abuse, highlighting the need for focused efforts to lower this number.
What are the Factors to Consider When Choosing a Substance Abuse Rehab Center?
Checking into rehab can be a life-changing journey to recovery. By understanding the importance of rehab, preparing for your stay, and choosing the right treatment center, you can set yourself up for success.
Aside from the center’s location, there are other factors to consider when choosing a substance abuse rehab center:
1. Availability of the type of treatment needed
Different rehab centers offer various treatment programs, and it is crucial to select one that aligns with the individual’s specific needs.
Common types of treatment include:
- Inpatient Programs: Intensive and residential, providing a structured environment for patients.
- Outpatient Programs: Flexible, allowing patients to live at home while attending treatment sessions.
- Long-term Residential: Extended care for severe addiction, typically lasting several months to a year.
- Short-term Residential: Intensive treatment over a shorter period, usually a few weeks to a few months.
2. Accreditation and Licensing
Accreditation and licensing are paramount when selecting a drug rehabilitation center. They guarantee that the center meets certain standards of quality and safety. These credentials ensure that the facility adheres to best practices and employs competent personnel.
The Joint Commission, Commission on Accreditation of Rehabilitation Facilities (CARF), and the National Association of Addiction Treatment Providers (NAATP) are organizations responsible for providing accreditation and licensing.
3. Staff Credentials and Experience
The qualifications and experience of the staff at a drug rehab center play a vital role in the effectiveness of treatment and support provided.
Look for facilities with professionally trained and credentialed staff members, such as licensed Clinical Social Workers, Counselors, Psychologists, Psychiatrists, and Certified Addiction Specialists.
4. Cost and Insurance Coverage
Evaluate the cost of treatment and check if the facility accepts your health insurance. It is crucial to understand the financial aspects, including co-payments, deductibles, and any available payment plans.
Some facilities offer sliding scale fees based on income or provide financial aid opportunities, making treatment more accessible.
How to Prepare for Your Stay in Rehab?
Relapse rates for substance use disorders range from 40% to 60%, a figure comparable to relapse rates for other chronic illnesses like hypertension or asthma. Nevertheless, these relapses can be mitigated through dedication, mental and emotional preparedness, and willingness to undergo treatment.
Preparation for a rehab stay begins with emotional readiness, as embracing the journey to recovery is a significant and transformative step. Once emotionally prepared, the next crucial step is preparing what you will leave behind—informing loved ones and handling work and financial obligations.
By taking these preparatory steps, you can ensure a smoother transition and focus entirely on your path to lasting sobriety.
1. Informing Family and Friends
Communicating your decision to enter rehab to family and friends is key to garnering their support and understanding. Their involvement can create a robust support network during challenging times.
Choose a quiet and private setting to discuss your plans, allowing your loved ones to provide encouragement and support throughout your recovery journey.
2. Handling Work and Medical Leave
Notifying your employer about your rehabilitation stay is crucial to secure legal protection for medical leave and avoid job dismissal.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) can help cover the cost of rehabilitation by offering the same coverage that was available before employment, including any mental health and substance misuse treatment included in the insurance plan.
3. Resolving Legal and Financial Matters
Addressing legal and financial issues before entering rehab ensures an undistracted focus on recovery.
Consider setting up automatic payments for bills or entrusting a reliable friend or family member to handle financial obligations on your behalf.
4. Packing Essentials and Avoiding Prohibited Items
Before packing for rehab, determine which items are allowed and which are prohibited. The treatment center will provide an inventory of items not allowed, helping you pack accordingly and avoid any complications upon arrival.
Bring only the essentials for your stay, as many common items may not be allowed in rehab facilities.
Methodology
The Rehab Index: America’s Addiction Care Landscape ranks US states based on various metrics to identify the effectiveness and accessibility of substance abuse rehabilitation services.
Our methodology incorporates a variety of authoritative data sources, each weighted according to its relative significance. These metrics are then aggregated to generate a total score for each state, offering a thorough assessment of how effectively each state supports substance abuse treatment.
For rehab costs, we utilized data from the National Center for Drug Abuse Statistics (NCDAS). States were ranked based on the average cost of residential and outpatient drug rehabilitation services.
For the number of substance abuse rehab facilities, we referred to the most recent National Survey of Substance Abuse Treatment Services (N-SSATS): 2020 report provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). The facility count was computed per 100,000 population for direct state-by-state comparison.
For SMHA expenditure, we referred to the recent SAMHSA Uniform Reporting System (URS).
For the number of practitioners authorized to treat opioid dependency, we used the SAMHSA Buprenorphine Practitioner Locator.
For the percentage of substance use treatment facilities reporting participation with insurers, we referred to the KFF analysis of the National Substance Use and Mental Health Services Survey (N-SUMHSS), 2022.
For the number of individuals with illicit drug use in the recent year and individuals needing but not receiving treatment at a specialty facility for substance use, we used data from the 2021-2022 NSDUH: Model-Based Estimated Totals.
For the drug overdose death rate, we referred to Drug Overdose Mortality by State by the National Center for Health Statistics.
