North Carolina has seen a steady and deeply concerning rise in substance use disorders over the past two decades, driven by waves of prescription opioids, heroin, and now fentanyl.
According to the North Carolina Department of Health and Human Services, over 4,000 North Carolinians died from drug overdoses in a recent year, with synthetic opioids responsible for the overwhelming majority of fatalities.
Urban areas like Charlotte, Raleigh, and Greensboro offer a broader range of treatment options, including inpatient rehab, detox, outpatient therapy, and MAT (medication-assisted treatment), but access in rural regions—particularly in the Appalachian west and coastal eastern counties—remains limited.
Many rural residents face transportation barriers, long waitlists, and a shortage of licensed behavioral health professionals. Telehealth services have expanded rapidly, especially during and after the COVID-19 pandemic, providing a critical bridge for remote care, but broadband access and digital literacy challenges persist in some of the state's poorest counties.
North Carolina has not fully expanded Medicaid as of recent years, which has left tens of thousands of low-income residents without affordable access to addiction treatment. Some pilot programs and state grants have attempted to fill the gap, but systemic underfunding continues to strain the treatment infrastructure.
Harm reduction efforts, including naloxone distribution, syringe service programs, and fentanyl test strip access, have grown significantly in cities and select counties, yet these services often face political and community resistance in more conservative areas.
Faith-based recovery programs and church-affiliated ministries are deeply embedded in North Carolina’s culture and serve as a primary access point for many seeking help—though not all offer evidence-based or clinically integrated services. Youth substance use, particularly involving vaping, alcohol, and marijuana, is a growing concern across suburban and rural school districts.
Prevention efforts are underway but face staffing shortages and variable curriculum implementation. The state’s Hispanic and immigrant populations face additional challenges, including language barriers, fear of deportation, and limited access to culturally competent care.
In response, some nonprofit organizations have begun offering bilingual services and community outreach initiatives focused on trust-building and education. Drug courts and diversion programs are expanding, particularly in urban counties, but rural access to alternative sentencing and post-incarceration support is inconsistent.
North Carolina’s diverse geography and population demand flexible, region-specific strategies to effectively address substance use. Continued investment in rural provider recruitment, Medicaid expansion, stigma reduction, and integrated care models will be essential for making treatment more accessible and sustainable statewide..
 | A Better Way Residential ServicesA Better Way Residential Services in Shannon, NC, offers quality addiction recovery solutions tailored to individuals seeking to overcome substance use disorders. Our facility provides a supportive and structured environment with a range of programs, including residential treatment, counseling, and life skills training. With a focus on personalized care and evidence-based practices, our dedicated team works collaboratively with clients to develop effective recovery plans that promote healing and resilience. At A Better Way, we believe in creating a nurturing community where individuals can rebuild their lives and achieve lasting sobriety. Contact us today to learn more about our services and how we can assist you or your loved ones on the journey to recovery. 220 Calvins Rd, Shannon, NC 28386 | Levels of Care:Inpatient Payment Options:Medicaid Private insurance Self-Pay Options Military Insurance | ||
 | A Helping Hand of WilmingtonA Helping Hand of Wilmington in Wilmington, NC, provides supportive recovery services for individuals facing substance use disorders and mental health challenges. Our programs include outpatient treatment, counseling, and community support designed to foster healing and personal growth. With a focus on individualized care and evidence-based practices, our compassionate team is dedicated to helping clients regain control of their lives and achieve lasting recovery. At A Helping Hand, we believe in the transformative power of support and connection. Contact us today to learn more about our services and how we can assist you or your loved ones on the path to recovery. 5013 Wrightsville Ave, Wilmington, NC 28403 | Levels of Care:DetoxOutpatient Payment Options:Medicaid Self-Pay Options Financial Aid Medicare | ||
 | A Life’s Journey Counseling CenterA Life’s Journey Counseling Center in Chapel Hill, NC, offers compassionate counseling services for individuals seeking support in overcoming personal challenges, including substance use disorders and mental health issues. Our center provides a range of therapeutic options, including individual therapy, group sessions, and holistic approaches tailored to meet the unique needs of each client. With a focus on creating a safe and nurturing environment, our experienced team is dedicated to empowering clients on their journey toward healing and self-discovery. At A Life’s Journey, we believe in the power of connection and understanding. Contact us today to learn more about our services and how we can assist you or your loved ones in navigating life’s challenges. 1709 Legion Rd suite 200, Chapel Hill, NC 27517 | Levels of Care:Outpatient Payment Options:Self-Pay Options Private insurance Medicaid Medicare | ||
 | A New DimensionA New Dimension in Lenoir, NC, offers innovative recovery services for individuals seeking to overcome substance use disorders and mental health challenges. Our programs focus on personalized treatment plans that incorporate evidence-based therapies, holistic approaches, and life skills training to support sustainable recovery. With a dedicated team of professionals, we create a nurturing environment where clients can thrive and build a brighter future. At A New Dimension, we believe in the transformative power of community and support. Contact us today to learn more about our services and how we can help you or your loved ones embark on a journey of healing and renewal. 116 Main St SW, Lenoir, NC 28645 | Levels of Care:Outpatient Payment Options:Self-Pay Options | ||
 | ACDM Assesment and Counseling of GuilfordACDM Assesment and Counseling of Guilford114 North Elm Street Suite 402 Greensboro NC, 27401 www.acdmassessment.com(336) 574-3772 | Payment Options:Self-pay options | ||
| ACPP - Cornerstone Christian CenterACPP - Cornerstone Christian Center | Payment Options:Financing available | ||
 | ACS - Appalachian Community ServicesACS - Appalachian Community Services100 Teptal Terrace Bryson City NC, 28713 www.acswnc.com(828) 488-3294 | Payment Options:Medicaid Private insurance Self-pay options Financial aid Medicare Military insurance | ||
 | Adapted Integrated Methods HealthAdapted Integrated Methods Health4004 Ben Franklin Boulevard Durham NC, 27704 www.aimhealthservicesnc.com(919) 471-5474 | Payment Options:Medicaid Private insurance Self-pay options Medicare | ||
 | ADATCADATC10720 Carmel Commons Blvd No. 350 Charlotte NC, 28226(704) 544-1156 | |||
 | Addiction Recovery Care AssociationAddiction Recovery Care Association1931 Union Cross Road Winston Salem NC, 27107 www.arcanc.org(336) 784-9470 | Payment Options:Daily: $400Private insurance Self-pay options Sliding scale payment assistance Financing available Monthly: $11 200 | ||
 | Addiction Recovery Center for MenThe Addiction Recovery Center for Men, situated at 1020 County Home Road, Henderson, NC 27536, is a private rehabilitation facility dedicated to providing treatment for a variety of substance abuse addictions, including alcoholism and opiate addiction. The center offers a supportive and structured environment for men seeking recovery, emphasizing personalized treatment plans that cater to individual needs. With a focus on holistic healing and evidence-based practices, the Addiction Recovery Center for Men aims to empower clients on their journey to sobriety and overall wellness. The facility is committed to fostering resilience and growth, helping men reclaim their lives from addiction in a compassionate and understanding setting. 1020 County Home Rd, Henderson, NC 27536 | Levels of Care:InpatientSober Living HomesAftercare Support12-Step Payment Options:Medicaid Private insurance Self-Pay Options Financial Aid Medicare | ||
| Adolescent AlternativesAdolescent Alternatives | Payment Options:Medicaid | ||
 | Advantage Behavioral Healthcare1600 East 5Th Street Lumberton NC, 28358 www.advantagebeh.com(910) 738-3571 | |||
 | Advantage Behavioral Healthcare405 Biggs Street Laurinburg NC, 28352 www.advantagebeh.com(910) 521-7288 | |||
| Advantage Behavioral HealthcareAdvantage Behavioral Healthcare | Payment Options:Medicaid | ||
 | Advantage Behavioral Healthcare732 Davis Avenue Whiteville NC, 28472 www.advantagebeh.com(910) 640-1038 | |||
| Agape HomesAgape Homes | Payment Options:Medicaid | ||
| Ainuddins HomeAinuddins Home | Payment Options:Private insurance | ||
 | Al Counseling609 Walter Reed Drive Greensboro NC, 27403 www.business.site(336) 299-4655 | Payment Options:Self-pay options | ||
| Alano - Tri CityAlano - Tri City | Payment Options:Free |
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Drug and alcohol rehab is a structured treatment program designed to assist individuals struggling with substance use disorders. These programs focus on helping participants stop using drugs or alcohol, learn about the nature of addiction, and develop coping strategies to maintain long-term sobriety. Rehab may include a combination of medical care, counseling, and therapeutic activities tailored to each individual’s needs.
Rehab programs generally fall into two primary categories:
The duration of rehab can vary significantly based on individual circumstances, the severity of addiction, and the chosen program. Traditional programs may last:
Participants can expect a structured environment that emphasizes healing and recovery. Key components of the rehab experience may include:
Many health insurance plans provide coverage for drug and alcohol rehab, but the extent of coverage can vary. It’s important to:
Detoxification, or detox, is the process of ridding the body of harmful substances while managing withdrawal symptoms. Detox may be necessary for individuals with severe physical dependence on drugs or alcohol, and it can involve:
Rehab centers utilize a variety of therapeutic approaches to address addiction. Common therapies include:
Aftercare is a crucial component of the recovery process, providing ongoing support to individuals after they complete their rehab program. Key aspects of aftercare include:
Yes, many rehab programs encourage family involvement as a critical aspect of healing. Family participation may include:
Selecting the right rehab center involves careful consideration of various factors:
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