Opioid, Fentanyl and Heroin Rehab Centers in Montana

How do I start methadone or buprenorphine treatment in Montana?

In Montana, you start methadone at a certified opioid treatment program, and you can start buprenorphine either at one of those programs or with an office-based prescriber. Federal rules in 42 CFR Part 8 allow methadone for opioid use disorder to be dispensed only through a certified opioid treatment program. Intake usually includes a medical history, an exam and a drug test. Clinic medical staff decide on take-home doses under the 2024 revision of 42 CFR Part 8, which ties them to time in treatment and clinical stability. Montana’s Behavioral Health and Developmental Disabilities Division (BHDD) grants state approval to treatment programs, including those that provide these medications. Methadone listings are on the Montana methadone clinics page.

Since 2023, any clinician in Montana whose DEA registration covers Schedule III drugs can prescribe buprenorphine without a special federal waiver. Telehealth access matters in a state where 60 percent of listed opioid programs are in rural areas. Montana Medicaid covers telehealth by live video and by telephone when it is clinically appropriate. You can browse buprenorphine and Suboxone clinics in Montana or telehealth options in Montana.

Extended-release naltrexone, a monthly injection, can only be started after a person has been through withdrawal and off opioids for about seven to ten days, because starting earlier can bring on sudden withdrawal. Naltrexone does not ease withdrawal symptoms.

What kinds of opioid treatment programs are available in Montana?

Montana listings for opioid use disorder range from daily dosing clinics to residential stays.

Opioid programs on Montana listings sit at a median elevation of 3,250 feet. Three in four are within 25 miles of a river, most often the Clarks Fork Yellowstone River. Billings Logan International is the airport nearest to the largest share of programs, and the median distance to the nearest airport is 5.9 miles. Sixty percent are within 25 miles of a named range or summit, most often the Bridger Range. Providers are concentrated in Yellowstone, Lewis and Clark, Flathead, Cascade and Missoula counties, and coverage is thin across the eastern plains.

Fentanyl in Montana’s drug supply is a practical reason to seek medically managed withdrawal or a medication start rather than stopping alone. You can browse detox programs in Montana.

Does Montana Medicaid pay for opioid treatment medications?

Montana Medicaid covers medications for opioid use disorder, though each clinic decides which ones it offers and bills. DPHHS runs the program as Montana Healthcare Programs. Coverage for lower-income adults was expanded through the HELP Program starting January 1, 2016. Most members are in Passport to Health, a primary care case management program. Under the HEART waiver, Medicaid also pays for short-term residential substance use stays. More on coverage is on the Medicaid rehab page.

Medicare Part B covers services at opioid treatment programs, including methadone or buprenorphine, counseling and testing. Montana programs that accept Medicare are on the Medicare rehab page for Montana.

People without insurance can ask about state-funded treatment, which BHDD supports with federal block grant money, alongside State Opioid Response funds. The Montana Opioid Abatement Trust also funds treatment and recovery work across the state’s abatement regions. Payment types, including sliding fees, are shown on each listing and on the state-funded rehab page for Montana.

Where can I get naloxone in Montana?

Montana pharmacies can dispense naloxone without an individual prescription under a statewide standing order issued by the state medical officer. DPHHS also distributes naloxone and fentanyl test strips at no cost through its naloxone program.

Overdose risk is higher after any period of not using, such as after detox, a residential stay or jail, because tolerance drops quickly. If someone may be overdosing, call 911 and give naloxone. Montana’s Help Save Lives from Overdose Act, passed in 2017, gives some protection from certain drug charges to people who seek medical help for an overdose.

Do residential programs in Montana accept people taking methadone or buprenorphine?

Some Montana residential programs accept people taking methadone or buprenorphine and some do not, so ask the admissions team first. Montana law adds a related safeguard: when a judge refers someone to a recovery residence, the options offered must include one that supports medication for substance use disorder. You can compare residential rehab in Montana.

Pregnancy and opioid treatment

Pregnant people in Montana receive priority admission at programs funded by the federal block grant. If no bed is available, those programs must provide interim services within 48 hours, under 45 CFR 96.131. A 2019 Montana amendment also shields pregnant women who seek treatment from certain drug statutes. See rehab for pregnant women in Montana.

Reading the Montana listings

Montana listings show each provider’s accreditation, languages, the populations it serves, payment types and location, as reported in public records and by the provider. For background on opioid treatment, see the national opioid treatment guide, or browse all treatment listings in Montana.