If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
If you are ready now, you have more options than you may think. Emergency departments, bridge clinics, walk-in assessments, telehealth, opioid treatment programs and detox units can often see people the same day or the next. If you are in danger, in withdrawal or in crisis, go to an emergency room or call 911 or 988 rather than waiting for a bed.
If it is an emergency
Go to the ER or call 911 if:
- Someone may have overdosed (unresponsive, very slow or stopped breathing, blue or gray lips)
- Withdrawal is severe: seizures, hallucinations, severe confusion, a racing heart or high fever
- You are having thoughts of suicide or self-harm. Call or text 988.
Alcohol and benzodiazepine withdrawal can be life-threatening. Do not try to get through it alone.
Fast options, from fastest to slowest
1. The emergency department
You can walk into any ER at any hour. Many now start treatment for opioid use disorder on the spot. Starting buprenorphine in the ER is recognized as a best practice, and a study from Yale found that people started on it in the ER were twice as likely to be in treatment 30 days later as people who were only handed a list of resources.
Some hospitals have a bridge clinic attached to the ER that provides low-barrier access to medication, help navigating to outpatient care and harm reduction. In some programs, treatment is available around the clock in the ER and same-day appointments are offered at the clinic during the week. Ask at the ER whether such a program exists.
2. Bridge clinics and walk-in clinics
Some clinics offer rapid access to medication for addiction treatment without an appointment or referral, with a medical and clinical assessment and a medication evaluation on the first visit. Search FindTreatment.gov and ask by phone whether a clinic takes walk-ins.
3. Opioid treatment programs and medication clinics
Many programs offer quick intake for people who need methadone or buprenorphine. Call and ask about same-day or next-day intake.
4. Telehealth
Some telehealth providers can assess you and start treatment within a day or two, including medication when appropriate. (See [Is Telehealth Addiction Treatment Effective? Pros, Cons and Costs].) Telehealth is not safe for severe withdrawal.
5. Detox and residential programs
Some programs can admit people within 24 to 48 hours, depending on bed availability, a medical assessment and insurance approval. Ask each program how soon it can admit you and what it needs first.
6. Outpatient programs
Intensive outpatient and outpatient programs often have shorter waits than residential beds and can start you on treatment while you wait. (See [PHP vs IOP: Partial Hospitalization and Intensive Outpatient Compared].)
How to move quickly
- Call the SAMHSA National Helpline at 1-800-662-4357 and say you need help today. Ask which programs have openings.
- Call three programs at once, and ask: Do you have an opening today or tomorrow? Do you offer walk-in assessments? What do I need to bring?
- Have key information ready: ID, insurance card, a list of medications and what you have been using.
- Ask your insurer for an expedited review if prior authorization is needed, and ask the program to help.
- Arrange transport and a support person for the day of admission.
- Be honest about what you use. It affects safety and the level of care.
If you are on a waiting list
- Ask about interim support: outpatient care, medication, peer groups, counseling or check-in calls. Federally funded programs generally must give priority to certain groups, such as pregnant women and people who inject drugs, so mention it if it applies.
- Join a mutual-help meeting today. Free groups meet daily, in person and online. (See [AA vs SMART Recovery vs Other Mutual-Help Groups: Which Fits You?].)
- Keep calling. Openings change daily.
- Protect yourself. Keep naloxone nearby if opioids are involved, avoid using alone and call 988 or 911 in a crisis. (See [How to Get Naloxone (Narcan): Where to Find It Free and When to Use It].)
Be careful about “instant bed” offers
Speed is a common sales tool. Be wary of:
- Free flights or gift cards to enroll right now. This can be a sign of patient brokering. (See [How to Find Affordable Rehab in Florida and Avoid Patient-Brokering Scams].)
- A call center that will not say who owns it
- Guarantees of a bed, a cure or insurance coverage
- Pressure to pay a deposit before you have a written estimate
A legitimate program will still verify your benefits, assess you and explain what it will cost. (See [How to Find a Legitimate Rehab Center: Accreditation and Red Flags] and [15 Questions to Ask a Rehab Center Before You Sign Up].)
What happens at a fast admission
- Assessment: medical and clinical questions about your use and health
- Level-of-care decision: which setting is safe for you. (See [Inpatient vs Outpatient Rehab: Which Level of Care Is Right for You?].)
- Detox, if needed (See [What Is the Difference Between Detox and Rehab?].)
- A treatment plan and a plan for what comes next
(See [What Happens During the First Week of Rehab?].)
Cost and insurance for a fast start
Do not let money stop you from calling. Programs can often check your benefits in minutes, and many have financial help. (See [Does Insurance Cover Rehab? How to Check Your Benefits Step by Step] and [Free and Low-Cost Rehab Options Without Insurance].)
If you are a family member
Help by making calls, gathering documents and arranging a ride. You cannot force an adult to enter treatment in most cases, but you can make it easier to say yes. (See [How to Talk to a Loved One About Addiction Without Pushing Them Away].)
Frequently asked questions
Can I get into rehab today?
Often yes, through an ER, a bridge clinic, a walk-in clinic or a program with an open bed. Availability depends on where you live.
What is the fastest way to start treatment?
For opioid use disorder, an ER or bridge clinic can start medication the same day. For other needs, call the SAMHSA helpline and several programs at once.
How long does it take to get into detox?
Some programs can admit within a day or two. Others have waitlists. Ask about openings and for interim support.
Do I need insurance approval first?
Often the program will verify your benefits quickly. Ask for an expedited review if needed.
What if there is a waitlist?
Ask about interim services, join peer support and keep calling other programs.
Is a fast admission safe?
It can be, with a proper assessment. Be careful of programs that rush you without verifying benefits or assessing your needs.
Sources
- SAMHSA. National Helpline and FindTreatment.gov. samhsa.gov
- Association of American Medical Colleges. Treating opioid addiction in the emergency department. aamc.org
- Public Health Institute, CA Bridge. Bridge model.
This article is for general information only and is not medical advice. In an emergency, call 911. Availability varies by location.