You likely need rehab if you have tried to cut down and could not, if stopping makes you physically sick, or if substance use is now driving decisions about your health, your safety, or your responsibilities. The level of care you need depends on one thing above all: how dangerous it would be for you to stop without medical supervision. If you are not sure where you land, a clinical assessment settles it in a single conversation, and you can verify your insurance benefits before you commit to anything.
TL;DR: The question is not whether your use is “bad enough.” It is whether stopping on your own is safe. Alcohol and benzodiazepine withdrawal can kill you. Opioid and stimulant withdrawal usually will not, but relapse risk during it is highest. Match the level of care to that risk, not to how ashamed you feel.
Key takeaways
- Two or more of the 11 DSM-5 criteria in a 12-month period meets the clinical definition of a substance use disorder. Six or more is severe.
- Withdrawal risk, not substance type, sets the level of care. Alcohol and benzodiazepine withdrawal can cause seizures and delirium tremens and needs medical supervision.
- Residential is indicated when use is uncontrolled, after a recent overdose, when a mental health condition is unmanaged, or when outpatient care has already been tried and did not hold.
- Outpatient can be enough when you are medically stable, housed, and have support at home.
- Coverage is checkable before you commit. Foundry accepts Colorado Medicaid in Regions 1 through 4 and is in network with six major commercial payers.
Call 911 now if any of this is happening
Some situations are past the point of self-assessment.
- Unresponsiveness, or breathing that is very slow, irregular, or absent
- A seizure, or repeated seizures
- Confusion, fever, heavy sweating, and shaking during alcohol or sedative withdrawal, which can indicate delirium tremens, a life-threatening form of alcohol withdrawal
- Hallucinations during withdrawal
- Chest pain, or vomiting severe enough to prevent keeping fluids down
- Thoughts of suicide or self-harm
If you suspect an opioid overdose, give naloxone if you have it, call 911, and stay with the person. Fentanyl raises overdose risk sharply, and more about that is on our page covering fentanyl addiction treatment.
For a mental health or suicide crisis, call or text 988 for the Suicide and Crisis Lifeline.
First question: do you meet the clinical criteria?
Substance use disorder is a diagnosis with a defined threshold, not a judgment call. The DSM-5, published by the American Psychiatric Association, lists 11 criteria. Meeting two or more within a 12-month period meets the definition.
Ask yourself whether, in the past year, you have:
- Used more, or for longer, than you intended
- Wanted to cut down or stop, and could not
- Spent significant time getting, using, or recovering from the substance
- Experienced cravings or strong urges
- Failed to keep up with work, school, or home responsibilities
- Kept using despite it damaging relationships
- Given up activities you used to care about
- Used in situations where it was physically dangerous
- Kept using despite a physical or mental health problem it was causing or worsening
- Needed more to get the same effect, which is tolerance
- Experienced withdrawal symptoms, or used to avoid them
Two to three criteria indicate a mild disorder. Four to five is moderate. Six or more is severe. Severity is not the same as level of care, but it is a reasonable starting point. Mild disorders often respond to outpatient treatment, while moderate and severe disorders, particularly those involving criteria 10 and 11, usually call for a medical evaluation first.
Criteria 10 and 11 matter most for safety. Tolerance and withdrawal mean your body has adapted to the substance, and that is what determines whether you can stop safely on your own. Alcohol makes the point sharply, which is why alcohol addiction treatment so often begins with a medical assessment rather than a therapy appointment.
Second question: which level of care fits?
Once a substance use disorder is established, the next decision is intensity. Clinicians use the ASAM Criteria, a framework from the American Society of Addiction Medicine that assesses six dimensions including withdrawal risk, medical conditions, mental health, readiness to change, relapse risk, and living environment. The goal is the least restrictive setting that still keeps you safe.
| Level of care | Who it fits | What it involves | Typical length |
|---|---|---|---|
| ASAM 3.7, medically supervised detox | High withdrawal risk, medical instability, or complicating conditions | 24/7 medical monitoring, withdrawal medication, nursing and physician care | Several days |
| ASAM 3.5, residential treatment | Unsafe or unstable living situation, significant impairment, unmanaged co-occurring mental illness | Live-in structured therapy with clinical and psychiatric support | Weeks |
| Partial hospitalization (PHP) | Needs daytime intensity without an overnight stay | Structured day programming, often 20 or more hours a week | Weeks |
| Intensive outpatient (IOP) | Medically stable, needs regular structured therapy | Roughly 9 to 20 hours a week of group and individual work | Weeks to months |
| Outpatient and virtual care | Lower intensity, medication management, longer-term follow-up | Weekly therapy, medication checks, relapse prevention | Ongoing |
Lengths above are general ranges and vary by person. Placement is not permanent either. People commonly step down from detox into residential, then into outpatient, and step back up if symptoms return.
A note on what Foundry offers. Our continuum runs medically supervised detox, residential and inpatient treatment, intensive outpatient, and virtual intensive outpatient care. We do not operate a partial hospitalization program. If PHP is the right fit for you, we will tell you that during your assessment.
Signs you need medically supervised detox
Detox is indicated when stopping carries real medical risk. Consider it if any of the following applies.
- You drink daily or near-daily, or take benzodiazepines regularly, and feel shaky, sweaty, nauseated, or anxious when you go without
- You have had a withdrawal seizure or delirium tremens before
- You have withdrawn before and needed emergency care
- You are using multiple substances, particularly alcohol or benzodiazepines alongside opioids
- You are pregnant and using
- You have a medical condition that unsupervised withdrawal could destabilize
Alcohol and benzodiazepine withdrawal are the two that can be fatal. Both can produce seizures and, in severe cases, delirium tremens. Medical supervision is the reason benzodiazepine addiction treatment rarely starts at home. Our medically supervised detox in Broomfield provides round-the-clock medical monitoring and withdrawal medication at ASAM level 3.7.
Detox stabilizes the body. It does not treat the disorder underneath, which is why it works best as the first step into ongoing care rather than as a standalone event.
Signs you need residential treatment
Residential care, ASAM 3.5, applies when the problem is not only withdrawal but everything around it. It fits if:
- Use is uncontrolled despite genuine attempts to stop
- You have overdosed recently
- A mental health condition such as depression, PTSD, or bipolar disorder is unmanaged alongside the substance use
- Outpatient treatment has already been tried and did not hold
- Home is not a safe or sober place to recover
- You cannot get through a day without using
Living on site removes the triggers and the logistics for long enough to do the actual clinical work. Our residential addiction treatment near Denver and our inpatient treatment program both treat substance use and co-occurring mental health conditions together rather than sequentially, using the Trauma-Integrated Care model developed by Dr. Michael Barnes. We also run a separate women’s residential program for people who need gender-specific care.
When outpatient care is enough
Outpatient treatment is a legitimate clinical answer, not a lesser one. It works when:
- You can stop safely without medical supervision
- You have stable housing and reliable transportation
- No recent overdose, and no unmanaged psychiatric symptoms
- Someone at home supports your recovery rather than undermining it
- Work, school, or caregiving responsibilities make a residential stay impractical and the medical risk is genuinely low
Intensive outpatient offers structured group and individual therapy while you live at home. Virtual IOP removes the drive, which matters across the Front Range. SAMHSA describes a full range of options running from outpatient counseling through residential care, and notes that FDA-approved medications are available for opioid and alcohol use disorder.
What happens when you call
An assessment answers the “do I need rehab” question properly, because it looks at the risks you cannot evaluate from the inside.
- Pre-screen. A short conversation about what you are using, when you last used, what withdrawal has looked like before, and whether anything urgent is happening right now.
- Benefits check. We run a verification of benefits to confirm what your plan covers and what it requires.
- Clinical interview and ASAM assessment. A clinician evaluates withdrawal risk, medical stability, mental health, and your living situation, then recommends a level of care.
- Medical exam and labs. Vitals, a physical check, and routine labs.
- Medication review. Staff go through your prescriptions and any over-the-counter medications, and discuss medication-assisted options where appropriate.
- Admission. Once the level of care is set and authorization is in place, we confirm arrival details and what to bring.
More detail on how admissions works is on our admissions page. Foundry Front Range is licensed by the State of Colorado and accredited by The Joint Commission, and our 44,000 square foot licensed medical facility sits about 30 minutes from Denver.
Bring a photo ID, your insurance or Medicaid card, a written list of your medications with doses, and prescription bottles where possible. Leave valuables and non-essential electronics at home. Expect the first days to focus on medical stabilization and safety rather than on therapy groups.
Will insurance or Medicaid cover it?
Coverage depends on your specific plan and on whether the care is found medically necessary, so the only reliable answer comes from a benefits check.
Foundry Front Range is in network with Aetna, Blue Cross Blue Shield, Cigna, Multi-Plan, Rocky Mountain Health Plan, and UnitedHealthcare, and accepts Colorado Medicaid in Regions 1, 2, 3 and 4. We work with most major insurance plans.
Medicaid coverage matters here more than it usually does. Residential and detox care that accepts Medicaid is genuinely hard to find in Colorado, which is why rehab that accepts Colorado Medicaid is a core part of what we do rather than an exception we make. For the wider context, we have written about how Medicaid funding changes are affecting access in Colorado.
To move faster, have ready your insurance or Medicaid card with the member ID, your date of birth, a list of current medications, and any relevant medical history. If you would rather not call your insurer yourself, tell us and we will start the verification.
What comes after treatment
Treatment stabilizes. What holds is the plan that follows it.
- Medication, where it is indicated. For opioid use disorder in particular, medication combined with counseling reduces overdose risk. Confirm your prescriber and first refill before discharge.
- A scheduled next appointment. Book outpatient or IOP before you leave, not after.
- Somewhere safe to live. Stable, sober housing does more for early recovery than almost anything else.
- Ongoing therapy. Cognitive behavioral therapy for coping skills, dialectical behavior therapy for emotional regulation, and eye movement desensitization and reprocessing (EMDR) where trauma is a factor.
- People. Our alumni program and our family program exist because recovery is harder alone, and because families usually need their own support.
Relapse is common and does not mean treatment failed. Build a written plan naming your triggers, your first three coping steps, and who you call. Share it with one person who will actually pick up.
Frequently asked questions
How do I know if I need rehab or just need to cut back?
If you have already tried to cut back and could not, that is one of the 11 DSM-5 criteria and a meaningful signal on its own. Cutting back works for people who can do it. Treatment is for people who have tried and found they cannot.
What are the signs I need inpatient rehab rather than outpatient?
Inpatient care is indicated when there is significant medical or psychiatric risk, unstable housing, active suicidal thoughts, or dangerous withdrawal from alcohol or benzodiazepines. If 24/7 supervision would meaningfully reduce your risk, inpatient is the right call.
Do I need detox, or can I just stop?
Stopping on your own is reasonable for many substances but dangerous with alcohol and benzodiazepines, where withdrawal can cause seizures and delirium. If you have withdrawn before and needed emergency help, or if you feel physically sick when you go without, get a medical evaluation first.
Do I need rehab after one overdose?
An overdose is a strong clinical signal regardless of what came before it, because it indicates a level of physiological risk that is not visible day to day. A clinical assessment after any overdose is worth doing even if you feel fine now.
Do I need rehab if I am pregnant?
Pregnancy with ongoing substance use warrants prompt clinical evaluation, since both withdrawal and continued use carry risk. Care should be coordinated between addiction treatment and your obstetric provider.
What if I have depression, PTSD, or anxiety as well?
Unmanaged mental health conditions alongside substance use typically call for integrated treatment rather than treating one and then the other. We treat co-occurring conditions within the same program.
Will rehab keep me from relapsing?
No program can promise that, and any that does should be treated with suspicion. Treatment reduces immediate risk and builds skills and supports. What sustains recovery is the aftercare plan, medication where indicated, and a relapse-prevention plan you actually use.
How long does treatment last?
Detox generally runs several days depending on the substance and how severe withdrawal is. Residential length varies considerably by clinical need. Your ASAM assessment sets the initial plan, and it gets adjusted as things change.
Can I go to rehab voluntarily, or do I need a referral?
Most people enter voluntarily. A referral can help but is not usually required. A confidential pre-screen is the fastest way to find out where you stand and what your plan covers.
Find out where you stand
Call (720) 807-7867 for a confidential assessment, or check your coverage online first. Either way, you will speak with someone who can tell you what level of care fits your situation.
Published: [DATE] Last updated: [DATE] Medically reviewed by: [NAME, CREDENTIALS, TITLE] (Link the name to that clinician’s own /employees/ bio page. The bio must be live, and the name and credentials must match exactly.)
This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are in crisis, call or text 988 for the Suicide and Crisis Lifeline. In a medical emergency, call 911.
