Many families across the Roanoke Valley have sat exactly where you are sitting, weighing what comes next. Roanoke Refuge is an outpatient addiction treatment center in Roanoke, Virginia, licensed by the Virginia Department of Behavioral Health and Developmental Services. We provide PHP and IOP for adults with substance use disorders throughout the Roanoke Valley and the surrounding Southwest Virginia region.
Substance use disorders are among the most prevalent and most treatable conditions in the United States. According to the most recent data from the Substance Abuse and Mental Health Services Administration, approximately 48.7 million Americans aged 12 or older met criteria for at least one substance use disorder in the past year, yet fewer than one in five received any treatment (SAMHSA, 2024).
That gap between the people who need treatment and the people who get it is the gap Roanoke Refuge was built to help close in this valley. Our treatment approach describes the clinical framework behind that work, including the ASAM level-of-care assessment for level-of-care placement and the evidence-based therapies the program uses.
Understanding Addiction as a Medical Condition
Here is how we talk about this with families on the phone. Addiction is a chronic, primary, biopsychosocial disease of the brain, defined as such by the American Society of Addiction Medicine, the American Medical Association, and the National Institute on Drug Abuse (NIDA, 2024). It is not a willpower problem and it is not a character flaw, and the shame people carry into our intake calls is one of the biggest reasons treatment gets delayed.
The brain changes that drive compulsive substance use are real and measurable. Neuroimaging studies document altered activity in:
- The prefrontal cortex, which governs executive control.
- The nucleus accumbens, which governs reward processing.
- The amygdala, which governs emotional response and stress reactivity.
These changes respond to treatment. Behavioral therapies and medications produce measurable neurobiological improvements that reduce craving, improve impulse control, and restore functional capacity over the course of sustained recovery. Brains heal. We have watched it happen.
Substances We Treat
Each substance is treated differently because the clinical picture is different. The level of care, the role of medication, the duration of treatment, and the specific therapy techniques all shift depending on what brought you here. The pages below outline what outpatient treatment looks like at Roanoke Refuge for each substance.
The most common reason adults across the Roanoke Valley enter outpatient treatment. Medical taper coordinated with our partner detox providers; ongoing pharmacological options on-site (naltrexone, acamprosate, disulfiram).
On-site MAT with buprenorphine and naltrexone (oral and Vivitrol). Methadone coordinated through community OTPs by federal law. PHP and IOP integrate medication, therapy, and recurrence-prevention planning.
MAT-anchored outpatient treatment for heroin use disorder. Detox is coordinated with our partner providers before PHP or IOP begins. Buprenorphine is the most common medication for the population we serve.
The substance behind most overdose deaths in the Roanoke Valley. Treatment is MAT-anchored with rapid stabilization, intensive outpatient programming, and naloxone access training for clients and families.
There is no FDA-approved MAT for methamphetamine. Treatment focuses on psychiatric stabilization, contingency-management approaches, cognitive interventions, and trauma-informed care across PHP and IOP.
Stimulant use disorder treatment is psychotherapeutic rather than medication-led. Cognitive Behavioral Therapy and dual-diagnosis care for co-occurring mood and anxiety conditions are central.
Benzodiazepine withdrawal can be life-threatening. We coordinate medical taper with your prescribing physician or a new outside prescriber, then carry the clinical work in PHP, IOP, or Telehealth IOP.
Treatment for prescription opioid, benzodiazepine, and stimulant use disorders. The clinical approach mirrors illicit-substance treatment with additional attention to the prescriber relationship that started the pattern.
The substances driving most of our admissions in the Roanoke region map closely to the national picture, with regional variations the team is trained to recognize. Whatever brought your family to this page, the chances are good that we have seen it before. Each substance category below has a dedicated page that goes deeper on the neurobiology, the clinical presentation, and what treatment looks like for that specific substance.
Specialized Populations
Two specialty areas come up regularly in admissions across the service area.
Veterans
Veterans carry a clinical picture that does not always show up on a standard intake form. The Salem VA Medical Center on Roanoke Boulevard serves veterans across a 26-county area of Southwest Virginia, and the substance use picture among the regional veteran population reflects the national reality of combat exposure, military sexual trauma, traumatic brain injury, and the difficulty of transition to civilian life. Our veterans addiction treatment approach is built for the clinical complexity veterans bring to outpatient care, with coordination with the Vet Center Roanoke at 350 Albemarle Avenue SW.
Adults with Co-Occurring Mental Health Conditions
Roughly half of the people who come to us for addiction treatment also live with a co-occurring mental health condition. That is not a sub-population. That is the room. Treating the substance use without treating the underlying mental health condition is like treating the smoke while leaving the fire burning, and we have seen what happens when one half of the picture gets ignored. Our integrated dual diagnosis program addresses both at the same time, in the same setting, and by the same clinical team.
Our Levels of Care
Most families ask what the schedule looks like before they ask anything else, so here is the structure. Roanoke Refuge offers two American Society of Addiction Medicine levels of outpatient care, plus a Telehealth IOP option for clients who cannot attend in person.
- Partial Hospitalization Program (PHP): full-day outpatient. 25 or more clinical hours per week across five days. The most intensive outpatient level of care, appropriate for clients stepping down from inpatient or for those with significant clinical structure needs.
- Intensive Outpatient Program (IOP): part-day outpatient. Nine or more clinical hours per week across three or more days. Designed for clients with moderate substance use disorder, a stable living environment, and meaningful engagement in the process.
- Telehealth IOP: The same IOP curriculum delivered virtually for clients in Botetourt County, Bedford County, and other parts of Southwest Virginia where the commute presents a barrier.
- Dual Diagnosis Track — Integrated treatment for co-occurring mental health and substance use disorders, woven through PHP and IOP rather than running as a separate program.
- Medication-Assisted Treatment: FDA-approved MAT prescribed on-site for opioid use disorder and alcohol use disorder, fully integrated with PHP, IOP, and Telehealth IOP. Buprenorphine, naltrexone, acamprosate, and disulfiram.
The First Step: Medically Supervised Detox
Detox is the part most people are scared of, and that fear is reasonable. For clients who are physically dependent on alcohol, opioids, or benzodiazepines, medically supervised detox is the required first step before beginning outpatient treatment.
Our admissions team coordinates with local detox partners and facilitates direct transitions from detox into PHP or IOP so there is no gap in care during the highest-risk window of early recovery. The handoff is something we plan, not something you have to figure out alone.
Barriers to Treatment We Help Navigate
The barriers that keep people from calling are usually not what people think they are. Stigma sits at the top of the list for almost every family we talk to. After that comes insurance confusion, then fear of what treatment will actually look like, then not knowing how to start the sentence. Childcare, transportation, and financial anxiety show up regularly in the first conversation too. Every one of these is real, and every one of them is something our admissions team actively helps navigate. There is no wrong way to start the call. The conversation is confidential, free, and carries no commitment.
Insurance Coverage
PHP and IOP are covered by most major commercial insurance plans and by Virginia Medicaid when deemed medically necessary. Free, confidential insurance verification happens before treatment begins so that the family has a clear picture of coverage and any cost share before any commitment is made.
Most commercial plans in Virginia — Aetna, Anthem, Cigna, United, Humana, and Blue Cross Blue Shield — cover outpatient PHP and IOP at parity with other medical-surgical benefits, per the federal Mental Health Parity and Addiction Equity Act and Virginia’s own parity provisions. Coverage details vary by plan tier and employer group, which is why benefits verification happens before any clinical commitment. The admissions team walks through deductible, copay, and prior-authorization requirements in plain language during the first call.
Virginia Medicaid clients are covered through the five managed-care organizations contracted to deliver behavioral health benefits across the Commonwealth: Aetna Better Health, Anthem HealthKeepers Plus, Sentara Community Plan, Molina Healthcare, and United Community Plan. PHP, IOP, and Telehealth IOP are all covered services under each plan when clinically indicated. The admissions team handles the Medicaid prior-authorization paperwork directly with the MCO so the client and family do not have to navigate it.
Local, regional, and accessible.
Roanoke Refuge serves adults across the Roanoke Valley — Roanoke City, Salem, Vinton, and the surrounding counties of Roanoke, Botetourt, and Bedford — from a facility at 1630 Braeburn Drive in Salem, just off I-81. Most clients are within a 30-minute drive of the program.
The path forward is a conversation, not a commitment. A short call with the Roanoke Refuge admissions team covers fit, level of care, and insurance — at no cost, with full confidentiality, before any clinical decisions are made. Insurance verification runs during the same call. Call (540) 900-0353 when you are ready.