Choosing outpatient substance use treatment

outpatient substance use

You have decided to seek treatment for alcohol and/or drug use. How do you choose the best program to meet your needs? Entering substance use treatment is a big commitment. Alcohol and drug use treatment is an experience that should have a long-lasting positive impact.  As with all health conditions, proper diagnosis and adherence to the treatment and continuing care plans are key components to your success.

Early intervention counseling or education, the treatment plan can be as simple as remaining abstinent while completing a few group sessions. For moderate to severe substance use, longer, more intensive counseling, aftercare and community support programs are beneficial to achieve lasting change.  Substance use intensive outpatient (IOP) treatment is usually the most successful level of outpatient treatment.

No matter the reason you choose to complete alcohol or drug use counseling your likelihood of successful outcomes are equally as good. Substance use treatment is a healthcare service, even if mandated by courts. Health insurance will pay for these services if they are deemed necessary to improve your health condition.

Research shows that clients who are required to receive services have outcomes as good as “voluntary” clients. Whether you chose treatment to improve your health or because of a legal charge, problems at school or work, etc., the process is largely the same.  If the treatment plan is followed through to the end, the outcome is significant improvement in your life. Substance use intensive outpatient treatment usually prevents the need for inpatient or residential treatment if accessed early enough.

The benefits of treatment might not be experienced until after several sessions or, sometimes, after completion of the process. Length of treatment may be more important than intensity. Diabetics don’t stop insulin because their blood sugar is stable. Heart disease and cancer patients don’t quit treatment because they don’t like going to the doctor.  When treatment seems uncomfortable, it is not time to quit. It is time to dig in, work closely with your counselor or doctor. Treatment works when the condition is properly diagnosed and the correct level of care is followed to completion. Don’t stop before the miracle happens to you!

Where to start, what to look for in an agency or facility

  • When initially searching for a program or facility on the internet, use caution when calling toll free numbers you aren’t familiar with. Toll free phone numbers often route you to a national call center rather than a local provider. First Step Services, LLC and other quality programs have local phone numbers which are answered in the treatment center by a staff member. (For more information, search the internet for “substance abuse treatment patient brokering.”)
  • Search the service you are looking for online to get a list of licensed and accredited programs, visit the actual websites of the program. Check the NCDHHS licensing for the division you are considering attending.
  • Look at the staff pages on the website of the advertised treatment center. Are there pictures and bios of the staff members? Search CARF accreditation, SAMHSA, state Department of Health and Human Services websites. Only choose state licensed facilities.
  • In NC, choose a program that is NC DHHS licensed for the level of care you are seeking. The best programs are accredited by Commission for Accreditation of Rehabilitation Facilities (CARF) or by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Agencies will have DHHS (Department of Health and Human Services) licenses and their accreditation openly displayed in the lobby.  If you do not see a current, verifiable license and CARF Accreditation, ask to see one. If the DHHS license and accreditation are not available find a different agency.
  • Ask: How long has the treatment program been operating? How long has it been in the Triangle area? Are the counselors full time employees or are they “contract” counselors?
  • Does the program have an onsite Medical Director or psychiatrist to assist with co-occurring mental conditions?
  • What levels of care are available? Does the program provide substance use intensive outpatient treatment?
  • Is the center in network with health insurance or does it bill “out of network”?
  • Quality programs, even those at the courthouse, and other agencies who assist legally mandated clients will have DHHS licenses and CARF Accreditation at all offices and locations. Ask to see licenses, accreditation and counselor credentials.
  • If you have a DWI, it is illegal in NC for anyone to require or pressure you to attend any specific DWI program, even at the court house. Report pressure to attend a specific agency to the NC DHHS and/or NC DWI Services.

When you arrive, what to look for, what to expect

  • Ensure the facility is private, clean and neatly organized.
  • Front desk and administrative staff should be friendly, welcoming and knowledgeable.
  •  When you meet with the counselor or therapist, look for degrees, licenses and/or certifications on the wall. If you do not see them prominently displayed, ask to see them.
  • If the center is unable to provide licenses/certifications/accreditation find a different program whose credentials are prominently displayed.
  • You should be welcomed immediately. If this is the first visit, the intake process should begin at your scheduled arrival time.
  • Ensure that parking is plentiful and well lit. You should feel safe outside the building as well as inside.  A safety office or staff member should be available to oversee safety in parking lots after dark.

The intake process during your first visit

  • You should be welcomed into an intake area with a staff member to assist with paperwork.
  • Intake includes gathering basic information such as address, contact information, health insurance, financial information guarantee of confidentiality statement, authorizations to release information, etc.
  • Bring your health insurance card. If you are on someone else’s plan, it is necessary to know the full name, date of birth, insurance ID and address of the insured.
  • People who are asked to stop using alcohol and/or drugs are, understandably, often resentful and angry. A comprehensive assessment could reveal a health condition that is, or can become, serious. The first reaction to a diagnosis or treatment recommendation may be anger and disbelief. Use the information above to choose a program rather than online reviews.

Your assessment

  • Like any health evaluation, substance use and mental health evaluations should be thorough, comprehensive and conducted by well trained, credentialed professionals. Assessments should be conducted in licensed, accredited facilities that use ASAM (American Society of Addictive Medicine) criteria and Department of Health and Human Services guidelines.
  • A comprehensive assessment will also help sort out severity, causes, triggers, related to the condition and help to develop treatment, discharge and continuing care plans.
  • Non accredited, non DHHS licensed NC DWI, NC DUI assessors might screen for a disorder, but often do not conduct a comprehensive assessment that provides sufficient information to create a holistic treatment plan.


  • All counselors should be credentialed as MSW, MA, LCAS, CSAC, LPC or LCSW.
  • Family services should be included or available at all levels of care.
  • A psychiatrist should be available to assist with treatment as needed.
  • A discharge and continuing care plan should be in place prior to completion of treatment.
  • Post treatment services should be available and easy to access. First Step allows recovering group graduates to continue attending their primary group for $5 per day.
  • Choose a program whose goal is to assist you in never having another problem with substance use.

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First Step services, LLC, locally owned and operated since 2001.  Take the First Step to a life free from substance use problems! 


“Treatment at First Step got me to open up about my addiction and my past. My overall communication skills improved. I made connections with others in recovery and was motivated to succeed in my recovery due to accountability and as a way to help others in their recovery I was also motivated to go to AA meetings and communicate there as well. I learned several coping skills that stuck as relapse prevention, which is very necessary to my recovery success and I gained more confidence and trust within myself. I am less fearful of recovery, but understand more clearly the consequences of relapse, and feel empowered and motivated to succeed in recovery, achieve my long term goals, and make my family proud.” Anonymous group member’s comments

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