Treatment continuum
Heroin rehab.
Medical detox, residential treatment, and structured step-down for heroin use disorder. SILC Health operates licensed programs in California and Georgia and integrates medication-assisted treatment (MAT) where clinically indicated.
Overview
Heroin rehab is the structured, professionally supervised treatment of heroin (and broader opioid) use disorder across the full continuum of care: medical detox to manage acute opioid withdrawal safely, residential treatment for ongoing clinical work, partial hospitalization or intensive outpatient step-down, and long-term aftercare including medication-assisted treatment (MAT) when clinically indicated. Today's heroin supply is contaminated with fentanyl in most U.S. markets — this means heroin detox at SILC includes overdose risk assessment, naloxone planning, and fentanyl-specific withdrawal management. SILC Health operates licensed heroin rehab programs in California and Georgia, accepts most major commercial insurance, and integrates buprenorphine (Suboxone) or naltrexone-based MAT into long-term care plans when appropriate. The most reliable predictor of sustained recovery from heroin use disorder is the combination of acute clinical treatment with structured, long-term aftercare — not detox alone.
Medically reviewed by Peter Scheid, MD
Medical Director, SILC Health
Clinically reviewed by Alexandra Truman, LMFT
Clinical Director, Substance Use Services — SILC Health
Last reviewed: June 16, 2026
Section 1
What this is.
Heroin rehab is the full clinical continuum for heroin (opioid) use disorder. It begins with medical detox to safely manage acute opioid withdrawal — which while not typically life-threatening on its own can be severe and is a major reason people return to use without medical support — and extends through residential treatment, step-down outpatient programming, and long-term aftercare that often includes medication-assisted treatment (MAT).
Today's heroin supply is rarely pure heroin. Most U.S. markets are dominated by heroin-fentanyl mixtures, and most heroin overdose deaths now involve fentanyl. This dramatically increases overdose risk during use, complicates withdrawal management, and shapes how SILC approaches heroin rehab — overdose education, naloxone planning, and fentanyl-specific protocols are part of the standard programming.
Heroin rehab is most effective when paired with medication-assisted treatment (MAT). Buprenorphine (Suboxone) and naltrexone are the two FDA-approved medications most commonly used for sustained recovery support. SILC's clinical and medical teams determine the appropriate MAT pathway during the residential phase and coordinate the medication plan with home-state providers when clients return out of state.
~75%
Share of U.S. opioid overdose deaths involving fentanyl in recent years — the heroin supply is now overwhelmingly fentanyl-contaminated.
Buprenorphine
FDA-approved medication for opioid use disorder, often dispensed as Suboxone (with naloxone). SILC integrates buprenorphine-based MAT when clinically indicated for sustained recovery.
Section 2
The continuum of care.
1. Medical detox (5–10 days, ASAM Level 3.7)
Heroin detox at SILC is medically managed with 24/7 nursing and physician oversight. Withdrawal symptoms are managed pharmacologically; vitals and cognitive status are monitored continuously; complications are escalated immediately. Detox is the foundation — the work that follows is harder without it. See more →
2. Residential treatment (30 / 60 / 90+ days, ASAM Level 3.1–3.5)
Residential — sometimes called "inpatient" — is the longest and most intensive phase. Clients live on-site, participate in structured clinical programming daily, attend individual and group therapy, work with family when appropriate, build recovery skills, and stabilize physically and emotionally. Length of stay is clinically determined; most clients with moderate-to-severe substance use disorder benefit from at least 60 days.
3. Partial Hospitalization (PHP) — day treatment (ASAM Level 2.5)
PHP is the first step down from 24-hour residential care. Clients spend most of the day in clinical programming (typically 5–6 days per week, 5–6 hours per day) but return to sober living or stable housing each night. PHP supports reintegration into community life while still providing intensive clinical structure.
4. Intensive Outpatient (IOP) — 9–15 hours weekly (ASAM Level 2.1)
IOP runs 9–15 hours per week across 3 days, allowing return to work, school, or family responsibilities. Clinical focus shifts toward relapse prevention, ongoing therapy, and community reintegration. IOP often runs in parallel with recovery fellowship participation.
5. Outpatient + aftercare (indefinite)
Standard outpatient — individual therapy, psychiatric medication management when indicated, group therapy with a community provider — extends after IOP and continues indefinitely. Aftercare also includes recovery fellowship participation, sober living when appropriate, and ongoing alumni programming.
Section 3
Who this is for.
Heroin use disorder is a chronic, treatable brain disease that develops when repeated heroin or opioid use rewires the brain's reward and stress systems. The DSM-5 grades severity by criteria met — impaired control, social impairment, risky use, and pharmacological dependence (tolerance and withdrawal).
Residential heroin rehab is most clearly indicated for clients with: any history of overdose (or near-overdose), repeated unsuccessful detox attempts, daily heroin or opioid use that has not responded to outpatient intervention, co-occurring mental health conditions complicating recovery, fentanyl-contaminated use patterns that elevate overdose risk, or an environment at home that makes recovery in place impractical.
Mild opioid use disorder may respond to outpatient MAT alone. A clinical assessment by a SILC admissions clinician determines the appropriate level of care. For heroin use disorder, the assessment specifically weighs overdose risk and the role of MAT in the recovery plan.
Section 4
A day in residential.
Residential heroin rehab is structured but not regimented. Most days at a SILC facility follow a clinical rhythm designed to balance therapeutic work, peer connection, physical wellness, and rest.
- •Morning: Wake, vitals check during detox phase, mindfulness or meditation, breakfast, community meeting.
- •Mid-morning to lunch: Individual therapy session or process group; psychiatric or medical check-ins when relevant.
- •Afternoon: Skill-building group (CBT, DBT, relapse prevention), or experiential work (movement, art, equine therapy depending on facility), or family session when scheduled.
- •Late afternoon: Physical wellness (exercise, beach walk at coastal California facilities, fitness room), peer time, dinner.
- •Evening: Recovery fellowship meeting (AA, SMART, or alternative), reflection group, journaling, rest.
Family communication is supported per the client's preference. Family programming — visits, family therapy sessions, and structured education on supporting recovery — is clinically encouraged once initial stabilization is complete, typically after the first 5–10 days.
Naltrexone
Extended-release naltrexone (Vivitrol) is FDA-approved for opioid use disorder maintenance after detox. SILC's medical team determines appropriateness during the residential phase.
ASAM Level 3.7
Medically managed inpatient detox with 24/7 nursing — the appropriate level for opioid withdrawal in clients with significant tolerance, complicating medical conditions, or polysubstance use.
Section 5
Insurance + cost.
Most major commercial insurance plans cover residential treatment at SILC facilities, including Aetna, Anthem Blue Cross / BCBS plans, Blue Shield of California, Cigna, UnitedHealthcare, Surest, MultiPlan / PHCS, ConnectiCare, Oxford / Harvard Pilgrim, NYSHIP (Empire Plan), Empire BCBS, and Prairie States Enterprises. Network status with any given carrier varies by SILC facility and the patient's specific plan.
Out-of-state insurance is commonly accepted under most plans' out-of-state benefit provisions — Empire BCBS (NY), BCBS Texas, BCBS Florida, Aetna nationwide plans, and UnitedHealthcare nationwide plans typically cover treatment at SILC California facilities.
The SILC admissions team verifies your specific benefits, in plain language, before any clinical commitment. Most insured clients pay a manageable share after coverage; private-pay and financing options are available for clients without insurance or whose plans don't cover residential treatment at the clinically indicated level.
See all accepted insurance carriers →Section 6
Where SILC operates.
SILC Health operates licensed substance use treatment programs in two regions: coastal California (San Diego County) and North Georgia (Towns County). Medical detox is available at Cove Detox (Carlsbad), Leucadia Detox (Encinitas), Seaside Detox (Oceanside), Harbor Detox (Dana Point), and Riverfront Recovery Center (Hiawassee, GA). Residential addiction treatment is anchored by Southern California Recovery Centers (Carlsbad) and Riverfront Recovery Center (Hiawassee, GA).
Roughly two-thirds of SILC's California admissions originate from outside California — the climate, the recovery community, the distance from triggers at home, and the depth of California's continuing-care ecosystem are the most common reasons families choose to travel here for treatment. The Riverfront catchment skews more regional — drive-distance from Tennessee, Kentucky, Indiana, and surrounding states.
See all SILC facilities →Related
Dig deeper.
First step
Heroin (Diamorphine) Detox
Medical management of heroin withdrawal — timeline, medications, and what to expect.
The diagnosis
Heroin rehab
Clinical overview, signs and symptoms, and how this condition is diagnosed.
The setting
Residential Treatment
What residential treatment looks like — daily schedule, therapies, length of stay.
Coverage
Insurance Verification
How SILC verifies your benefits — including out-of-state coverage.
The process
What to Expect
From the first phone call through arrival at the facility — step by step.
Co-occurring
Dual Diagnosis
Treating substance use and mental health conditions together.
FAQ
Frequently asked questions.
- How long does heroin detox take?
- Acute opioid withdrawal typically peaks 24–72 hours after last use and resolves over 5–10 days. Post-acute withdrawal symptoms (sleep disturbance, mood instability, cravings) can extend for weeks to months and are part of why residential treatment after detox produces better outcomes than detox alone.
- Is heroin withdrawal dangerous?
- Opioid withdrawal is severely uncomfortable but not typically life-threatening in otherwise healthy adults. However, dehydration from vomiting and diarrhea can become dangerous, and the relapse-and-overdose risk during withdrawal is significant. Medical detox manages symptoms, prevents dehydration, and bridges to MAT where appropriate.
- What is MAT and does SILC offer it?
- Medication-Assisted Treatment uses FDA-approved medications (buprenorphine, naltrexone, methadone) alongside behavioral therapy to treat opioid use disorder. SILC integrates MAT when clinically indicated — most commonly buprenorphine (Suboxone) or extended-release naltrexone (Vivitrol). The medical team determines the appropriate pathway during the residential phase.
- How is heroin rehab different now that fentanyl dominates the supply?
- Most modern heroin is contaminated with fentanyl, which means overdose risk is substantially elevated and withdrawal patterns can include fentanyl-specific features. SILC's clinical protocols account for this — overdose education, naloxone (Narcan) planning, fentanyl test strip awareness, and longer-tail withdrawal management are part of standard programming.
- How long is residential heroin rehab?
- Most clients with moderate-to-severe heroin use disorder benefit from at least 60 days of residential treatment, often 90+ days. Length of stay is clinically determined based on progress, complexity of co-occurring conditions, and the MAT plan being established for ongoing care.
- What insurance does SILC accept for heroin rehab?
- Most major commercial plans, including Aetna, Anthem Blue Cross / BCBS, Blue Shield, Cigna, UnitedHealthcare, Surest, MultiPlan / PHCS, ConnectiCare, Oxford / Harvard Pilgrim, NYSHIP, Empire BCBS, and Prairie States Enterprises. Out-of-state plans are commonly accepted under out-of-state benefit provisions.
- Will I need to take medication for the rest of my life?
- Not necessarily. MAT duration is individualized. Some clients use MAT for months to support stabilization; others use it for years; some long-term outcomes are best supported by long-term MAT. The medical team works with the client and family to set a plan that reflects clinical evidence and the client's recovery goals.
- What happens after heroin rehab ends?
- Continuing care typically includes outpatient MAT maintenance, individual therapy, group therapy, recovery fellowship participation, sober living when appropriate, and ongoing psychiatric care for co-occurring conditions. SILC coordinates direct handoff with home-state providers for clients returning out of state, including MAT prescription continuation.
- Does SILC treat heroin addiction with co-occurring mental health conditions?
- Yes. Heroin use disorder co-occurs frequently with depression, anxiety, PTSD, and trauma — particularly in clients whose use began as self-medication. SILC programs treat both presentations concurrently rather than sequentially.
- What happens if I overdose during withdrawal or treatment?
- SILC's medical detox facilities are staffed 24/7 with naloxone (Narcan) immediately available and physician oversight. Overdose risk is highest in the period after detox if a client uses again with reduced tolerance — overdose-prevention education, naloxone training for clients and families, and long-term recovery planning all reduce this risk.
Talk to admissions
Recovery starts with a call.
One call confirms benefits, walks through what arrival looks like, and sets a clear plan from detox through aftercare.