Virginia has over 450 licensed substance abuse treatment facilities and recorded approximately 2,800 drug overdose deaths in 2023. The commonwealth's opioid crisis prompted the Governor to declare a public health emergency in 2016, and Virginia has since invested heavily in expanding treatment access. The Department of Behavioral Health and Developmental Services (DBHDS) oversees the publicly funded behavioral health system through 40 Community Services Boards (CSBs) across the state.
Substance Abuse Statistics in Virginia
According to NSDUH data, approximately 7.2% of Virginia adults reported a substance use disorder in the past year. Fentanyl and other synthetic opioids drive the majority of overdose deaths, with fentanyl-involved fatalities increasing over 85% between 2019 and 2023. While the opioid crisis largely began in rural southwestern Virginia — historically coal country — it has since spread statewide, with Northern Virginia, Hampton Roads, and Richmond all severely affected.
Alcohol misuse is the most prevalent substance issue, accounting for approximately 30% of all treatment admissions. Methamphetamine use has increased significantly in rural western and southwestern Virginia, while cocaine remains a concern in urban areas.
Types of Treatment Programs Available
Medical Detox: Medically supervised detox programs are available across Virginia, with concentrations in Northern Virginia, Richmond, Virginia Beach/Norfolk, and Roanoke. These programs provide 24/7 medical monitoring during the withdrawal phase.
Residential/Inpatient Treatment: Virginia has over 130 residential treatment facilities offering 28-day to 90-day programs. Evidence-based approaches include CBT, trauma-informed care, 12-step facilitation, and therapeutic community models. Specialized programs exist for women, veterans, adolescents, and individuals with co-occurring disorders.
Outpatient Programs: IOPs and PHPs are widely available. Virginia's ARTS benefit (see below) has dramatically expanded access to outpatient SUD services through Medicaid, including peer recovery support services and care coordination.
Medication-Assisted Treatment (MAT): Virginia has over 80 Opioid Treatment Programs and a growing network of buprenorphine prescribers. Virginia Medicaid covers all three FDA-approved MAT medications. The Virginia Department of Health also operates the REVIVE! program, which provides free naloxone training and distribution.
Virginia's ARTS Benefit
In 2017, Virginia launched the Addiction and Recovery Treatment Services (ARTS) benefit — a landmark Medicaid redesign that transformed how addiction treatment is covered and delivered. ARTS removed prior authorization requirements for many SUD services, expanded the provider network, added peer recovery support services, and aligned reimbursement rates to incentivize quality care. Since ARTS launched, the number of Medicaid members receiving SUD treatment has increased by over 60%, and the rate of all-cause inpatient admissions among members with SUD has decreased significantly.
Insurance & Payment Options
Medicaid: Virginia expanded Medicaid under the ACA in January 2019, extending coverage to adults earning up to 138% of the federal poverty level. Combined with the ARTS benefit, this expansion has been transformative — Virginia Medicaid now covers the full continuum of SUD care including assessment, detox, inpatient, outpatient, MAT, peer support, and recovery housing.
Private Insurance: Major carriers including Anthem, CareFirst Blue Cross, UnitedHealthcare, Aetna, and Optima cover SUD treatment under federal parity requirements. Verify your insurance coverage to explore your options.
State-Funded Programs: DBHDS funds behavioral health services through 40 CSBs. Uninsured individuals can access assessment, outpatient counseling, and crisis services through their local CSB.
Finding Help in Virginia
SAMHSA National Helpline: Call 1-800-662-4357 for free, confidential, 24/7 referrals.
Virginia's CONNECT Helpline: Call 1-855-292-3019 for behavioral health crisis support and referrals to local CSBs, available 24/7.
REVIVE! Naloxone Program: Visit the DBHDS website for free naloxone training and distribution.