Questions our admissions team hears most.

It is a disease, and most of the families we work with have spent years being told otherwise. We want to put that down first because the shame underneath this question is what keeps people from making the call. Addiction is a chronic brain disorder characterized by compulsive substance use despite harmful consequences, defined as such by the American Society of Addiction Medicine, the American Medical Association, the National Institute on Drug Abuse, and the World Health Organization. The neurobiological evidence is well-established through decades of neuroimaging and pharmacological research. The disease framework is not an excuse. It is the clinical foundation for understanding why treatment works and why judgment alone does not.

Physical dependence means the body has adapted to a substance and will produce withdrawal symptoms when it is removed. Addiction involves compulsive use despite harmful consequences. Dependence can occur without addiction, as in a pain client taking opioids exactly as prescribed. Addiction can occur without significant physical dependence, as in cocaine use disorder. Both frequently co-occur.

This is the question families ask after the second or third treatment episode, and we hear it as the question underneath the question, which is whether any of it matters. It does. Recurrence rates for addiction, approximately 40 to 60 percent, are similar to recurrence rates for other chronic conditions such as hypertension (50 to 70 percent) and type 2 diabetes (NIDA, 2024). We do not conclude from those numbers that treatment for hypertension or diabetes does not work. A return to use is a clinical event that signals a need to adjust treatment intensity or approach. It does not erase prior progress.

PHP, at ASAM Level 2.5, involves 25 or more hours of programming per week across five days. IOP, at ASAM Level 2.1, involves a minimum of nine hours per week across three or more days. PHP is appropriate for higher clinical acuity. IOP is appropriate for clients who are more clinically stable and can manage with a less intensive structure. Many clients step down from PHP to IOP after two to six weeks of demonstrated stability.

Medically supervised detox happens with our partner providers in the Roanoke Valley before PHP or IOP begins. Our admissions team coordinates the referral and arranges direct admission into PHP or IOP once the client is medically stable. The detox page covers the process in detail.

Yes. Roanoke Refuge prescribes FDA-approved MAT medications on-site, including Suboxone and buprenorphine. Methadone, which by federal law is dispensed only through certified Opioid Treatment Programs, is coordinated with community OTPs.

PHP typically runs two to six weeks before step-down to IOP. IOP typically runs eight to 12 weeks. The numbers are averages. Treatment length is individualized based on clinical progress, the treatment plan, and the level of care needed at each stage. Aftercare planning extends beyond the formal program for most clients.

That is the norm, not the exception, and we want you to hear that before anything else. Roughly half of people in addiction treatment also live with a co-occurring mental health condition. You are not unusual. Our integrated dual diagnosis program treats both at the same time, in the same setting, and by the same clinical team.

The honest answer depends on the co-occurring picture and your history with psychiatric medication, and that question will be worked through carefully with you rather than handed down. For clients whose treatment plan includes medication, prescribing happens through an outside psychiatric provider in the Roanoke region and our team coordinates around the prescriber's recommendations. On-site psychiatric prescribing is not part of the program.

Cell phones are permitted on-site but must be silenced and put away during group sessions to protect the confidentiality and therapeutic focus of the group.

We connect clients with local transportation resources in the Roanoke area, including public transit options and community transportation assistance programs. The admissions team also works through scheduling that accommodates a longer drive for clients in Botetourt, Bedford, and the outer counties.

No. This is the fear that keeps people from using the benefits they already have, and we want to answer it plainly. Your employer cannot access your treatment records or confirm your enrollment without your written consent. Substance use disorder treatment records are protected by HIPAA and additionally by 42 CFR Part 2, which provides stronger privacy protection than standard medical records. FMLA leave protects your job during treatment without requiring you to disclose the specific nature of your health condition.

That depends on your insurance coverage. Free, confidential insurance verification happens before any commitment is made, and the admissions team walks the family through coverage and any cost share before treatment begins. Self-pay and sliding-scale options are available for clients who are uninsured or underinsured.

Yes, with the client's consent. Family involvement is a core clinical component, not a sidebar. The Family Program structures the work, including family therapy sessions, family education, and peer-support referrals such as Al-Anon and Nar-Anon.

Yes, and many families in the Roanoke Valley do exactly that as their first move. Please call. Family members can call our admissions team directly to discuss the situation, ask questions, and get a clinical perspective on the options. We will not tell anyone what to do. The decision to enter treatment has to belong to the person who needs it. What we will do is sit with you, listen to what is happening at the kitchen table, and offer honest guidance on what the situation may require clinically.

Yes, with very limited legal exceptions for immediate safety. This is the question that has to be answered before most clients will tell anyone what is happening, and the answer is plain. Substance use disorder treatment records are protected by HIPAA and 42 CFR Part 2. We cannot confirm or deny that you are a client without your written consent.

Call or text the 988 Suicide and Crisis Lifeline. If you are a veteran, call or text 988 and press 1 for the Veterans Crisis Line. If you are in immediate physical danger, call 911 or go to the nearest emergency room.