Opioid, Fentanyl and Heroin Rehab Centers in Maryland

How do I start methadone or buprenorphine treatment in Maryland?

Starting methadone in Maryland means enrolling at a certified opioid treatment program, while buprenorphine can come from one of those programs or from an office-based prescriber. Intake usually includes a medical assessment, a drug test and a first dose on site. Listed programs appear on the methadone clinics in Maryland page.

Federal rules in Title 42 of the Code of Federal Regulations, Part 8, allow methadone for opioid use disorder to be dispensed only through a certified opioid treatment program. In Maryland, the State Opioid Treatment Authority within the Behavioral Health Administration oversees these programs, which pair regular dosing with counseling.

The Food and Drug Administration lists three medications for opioid use disorder: methadone, buprenorphine and naltrexone, and each acts on the body in a different way. Buprenorphine no longer needs a special federal waiver, so any clinician with the right prescribing registration can offer it. Extended-release naltrexone is a monthly shot started only after withdrawal ends.

Maryland Medicaid, also called Medical Assistance, handles opioid treatment through the Public Behavioral Health System, which Carelon Behavioral Health runs apart from the HealthChoice plans. Medicare Part B also carries a benefit for opioid treatment program services. People without coverage can ask a program about public funding through the Behavioral Health Administration.

Buprenorphine and naltrexone

Prescribing buprenorphine no longer requires a special federal waiver. Any clinician whose DEA registration covers these medications can prescribe it in Maryland. Clinics that list it are gathered on the Suboxone clinics in Maryland page. Extended-release naltrexone is a monthly injection given only after withdrawal is finished, usually seven to ten days without opioids. Starting it sooner can bring on sudden withdrawal.

Maryland Medicaid covers telehealth by video and also allows audio-only visits. Federal rules on starting buprenorphine by telehealth have changed several times, so ask the prescriber which rule applies to you. Remote options are listed under telehealth rehab in Maryland.

What kinds of opioid treatment programs are available in Maryland?

Maryland listings for opioid use disorder include several levels of care:

Fentanyl in the unregulated drug supply is one reason many people choose medically managed withdrawal or a supervised medication start instead of stopping alone. Fentanyl withdrawal can last longer, and starting buprenorphine may need a different schedule. Withdrawal care is a first step, not complete treatment. Options are on the Maryland detox page, and many people go on to an intensive outpatient program or ongoing medication.

Residential programs in Maryland differ on whether they admit people already taking methadone or buprenorphine, so ask the admissions team before you arrive. Some programs prescribe buprenorphine on site. Others arrange methadone dosing with a nearby opioid treatment program. Compare live-in options on the residential rehab in Maryland page.

Does Maryland Medicaid pay for opioid treatment medications?

Maryland Medicaid, also called Medical Assistance, handles substance use treatment, including opioid treatment, through the Public Behavioral Health System. That system runs separately from the HealthChoice managed care plans. Carelon Behavioral Health administers it for the Maryland Department of Health. Questions about coverage for methadone, buprenorphine or naltrexone can go to Carelon or to the program’s billing office. Maryland expanded Medicaid in 2014, which opened coverage to more low-income adults. More detail is on the Medicaid rehab page.

Medicare Part B includes a benefit for services at opioid treatment programs. Programs that take it are listed under Medicare rehab in Maryland. If you have no coverage, you can ask about public funding through the Behavioral Health Administration. Programs that report state funding, sliding fees, cash or private insurance appear on the state-funded rehab in Maryland page.

Where can I get naloxone in Maryland?

You can get naloxone at any Maryland pharmacy without a prescription under a statewide standing order. It is also sold over the counter. Overdose Response Programs authorized by the Maryland Department of Health give out naloxone free, along with fentanyl and xylazine test strips. Some counties offer home delivery.

Tolerance drops quickly after withdrawal, a hospital stay, jail or residential treatment. After a break, an amount that was once usual can cause an overdose. Keeping naloxone nearby and not using alone matter most in the weeks after time away from opioids. In an emergency, call 911. Maryland’s Good Samaritan law, Criminal Procedure 1-210, protects people who seek help in good faith from arrest, charge or prosecution for listed violations. The same protection covers the person having the emergency.

How can I compare opioid listings across Maryland?

Start by comparing listings on medication offered, level of care, payment and location. Then call two or three programs to ask about wait times. Opioid listings in Maryland are 55 percent urban, 36 percent in towns and 9 percent rural, with a median elevation of 150 feet. Almost all, 96 percent, sit within 25 miles of a river, most often the South Branch Patapsco River. Three in four have a major airport as the nearest one, most often Baltimore/Washington International Thurgood Marshall, at a median of 12.1 miles. Listings also show accreditation, languages spoken and populations served, such as veterans, teens or Spanish speakers. Browse all treatment listings in Maryland or read the national opioid treatment guide.

Pregnancy and opioid treatment

Pregnant people receive priority admission at publicly funded programs under federal block grant rules. Behavioral Health Administration guidance for pregnant women and women with children has long given the same priority for placement. Many opioid treatment programs in Maryland list prenatal coordination. Programs that note services for pregnant people are gathered on the rehab for pregnant women in Maryland page.