Rehab Cost in Louisiana: 2026 Treatment Cost Guide
Louisiana recorded 2,413 drug overdose deaths in 2023 — the worst year in state history — pushing the overdose rate to 52.6 per 100,000 residents, approximately 62% above the national average. The state ranks among the 10 worst nationally for overdose mortality, with deaths nearly tripling since 2013 (Louisiana Department of Health, LODSS).
But there is dramatic news from 2024: Louisiana saw a 35.2% decline in overdose deaths from the 2023 peak — one of the largest single-year improvements in the nation. Expanded naloxone distribution (200,000+ doses between 2022-2024), Medicaid-funded treatment access, and growing harm reduction infrastructure appear to be making a measurable difference.
Louisiana’s addiction crisis is distinctly polysubstance. While fentanyl is the leading driver, the state’s official attribution rate of 46% is suppressed by coroner reporting practices — NMS Labs toxicology testing found 58.4% fentanyl positivity among tested remains. Methamphetamine, cocaine, and fentanyl frequently appear in combination, creating complex treatment needs.
This guide breaks down what addiction treatment costs in Louisiana in 2026, how Medicaid expansion has transformed treatment access, and how to find affordable care whether you’re in New Orleans, Baton Rouge, Shreveport, or rural Louisiana.
Rehab Costs in Louisiana: 2026 Overview
| Treatment Type | Without Insurance | With PPO Insurance | Duration |
|---|---|---|---|
| Medical Detox | $1,200 – $7,000 | $400 – $2,500 | 5-14 days |
| Inpatient Rehab | $10,000 – $38,000 | $4,500 – $16,000 | 30 days |
| Luxury/Executive Rehab | $35,000 – $90,000+ | $10,000 – $30,000 | 30 days |
| Outpatient IOP | $2,500 – $9,000 | $800 – $4,000 | per month |
| Standard Outpatient | $1,000 – $4,000 | $300 – $1,200 | per month |
| Medication-Assisted Treatment | $200 – $750/month | $20 – $180/month | ongoing |
| Sober Living Housing | $400 – $1,500/month | typically not covered | ongoing |
Source: SAMHSA N-SSATS 2022; facility-reported data aggregated by ClearCostRecovery, 2026.
Louisiana treatment costs run approximately 10-20% below the national average, reflecting the state’s lower cost of living. New Orleans programs tend to price at the higher end of the range, while facilities in Baton Rouge, Shreveport, Lafayette, and rural areas are among the most affordable in the South.
Why Louisiana’s 2016 Medicaid Expansion Changed Treatment Access
Louisiana’s July 2016 Medicaid expansion under Governor John Bel Edwards represents the single most significant change to addiction treatment access in the state’s history:
Scale of Coverage: Approximately 1.9 million Louisianians — about 1 in 4 nonelderly residents — are now enrolled in Medicaid. The expansion group alone includes approximately 400,000 adults who previously had no affordable coverage pathway.
Uninsured Rate Impact: Louisiana’s uninsured rate dropped from approximately 22% in 2013 to 8.8% in 2023. While 8.8% remains above the national average (reflecting deep poverty), the improvement is dramatic — more than halved in a decade.
Treatment Access: Medicaid expansion made comprehensive SUD treatment — including inpatient rehab, detox, MAT, and outpatient therapy — accessible to hundreds of thousands of Louisianians who previously had to rely on limited state-funded programs or pay out of pocket.
The Unwinding Challenge: During the 2023-2024 Medicaid unwinding (redetermination process), 112,000+ Louisiana residents transitioned from Medicaid to ACA marketplace coverage. Louisiana’s marketplace enrollment surged 38% to a record 292,994 in 2025, with 96% receiving subsidies averaging $593/month and net premiums averaging just $50/month.
Louisiana’s Treatment Landscape
Louisiana has 310 licensed treatment facilities, including 135 offering inpatient or residential programs (Source: SAMHSA Treatment Locator / LDH OBH). The state’s treatment system is overseen by the Louisiana Department of Health, Office of Behavioral Health (OBH).
Distribution of Treatment Facilities in Louisiana
- New Orleans metro (Orleans, Jefferson, St. Tammany parishes): ~75 facilities (largest concentration)
- Baton Rouge metro (East Baton Rouge, Ascension, Livingston): ~45 facilities
- Shreveport/Bossier City (northwest): ~30 facilities
- Lafayette/Acadiana region: ~25 facilities
- Lake Charles/Southwest Louisiana: ~15 facilities
- Monroe/Northeast Louisiana: ~15 facilities
- Rural parishes (Concordia, Tensas, Madison): Limited — many parishes have no residential treatment
The New Orleans metro area has the highest treatment density but also the highest overdose concentration. Rural Louisiana parishes — particularly in the northeast Delta region and southwest parishes — face critical access gaps.
Key Louisiana Treatment Regulations
Medicaid Expansion: Louisiana’s 2016 expansion covers adults up to 138% FPL. The Medicaid SUD benefit includes MOUD (medications for opioid use disorder: buprenorphine, methadone, naltrexone), inpatient detox, residential treatment, IOP, and outpatient counseling. The state has prioritized SUD treatment within its Medicaid benefit structure.
OBH Licensing: All SUD treatment providers in Louisiana must be licensed through the Office of Behavioral Health. Standards cover staffing, clinical protocols, and quality of care. OBH also manages regional behavioral health authorities that coordinate state-funded services.
Naloxone and Harm Reduction: Louisiana has expanded naloxone access through standing orders at pharmacies and community distribution programs. Between 2022-2024, the state distributed 200,000+ naloxone doses and 100,000+ fentanyl test strips — a significant investment in harm reduction.
HOPE Council: Louisiana’s Heroin and Opioid Prevention and Education (HOPE) Advisory Council coordinates the state’s opioid response, publishes annual reports, and recommends policy changes to the legislature and governor.
Insurance Coverage in Louisiana
Louisiana has an uninsured rate of 8.8% (U.S. Census Bureau, 2023 ACS) — approximately 404,000 uninsured residents. While still above the national average, this reflects enormous improvement from 22% in 2013 prior to Medicaid expansion.
Major Insurance Carriers in Louisiana
Blue Cross Blue Shield of Louisiana — Dominant commercial carrier with the broadest statewide network. Covers most licensed treatment facilities. Comprehensive behavioral health benefits.
Louisiana Healthcare Connections (Centene) — Major Medicaid managed care organization. Serves a significant portion of Medicaid enrollees. Covers comprehensive SUD treatment.
Aetna Better Health — Medicaid managed care carrier. Growing provider network. Covers addiction services for Medicaid enrollees.
UnitedHealthcare Community Plan — Medicaid managed care presence. Optum behavioral health network.
Ambetter (Centene) — Major ACA marketplace carrier with competitive premiums. 96% of enrollees receive subsidies.
Vantage Health Plan — Regional carrier with strong Louisiana network. Available through marketplace and employer plans.
What Insurance Covers in Louisiana
Under the ACA and federal parity law, your health insurance must cover:
- Inpatient/residential treatment: 24/7 care in a licensed facility
- Partial hospitalization (PHP): 6+ hours/day of structured programming
- Intensive outpatient (IOP): 9-12 hours/week of group and individual therapy
- Standard outpatient therapy: Weekly counseling sessions
- Medication-assisted treatment: Buprenorphine, methadone, naltrexone, and monitoring
- Medical detoxification: Medically supervised withdrawal management
- Psychiatric care: For co-occurring mental health disorders
- Family therapy: Sessions with family members as part of treatment
Don’t Have Insurance in Louisiana?
If you’re among the 8.8% of Louisiana residents without insurance:
Louisiana Medicaid: If your income is below 138% FPL ($20,783/individual, $42,783/family of four), you likely qualify. Apply at healthy.la.gov or call 1-888-342-6207. Louisiana’s generous Medicaid expansion means most low-income adults have a coverage pathway.
ACA Marketplace (HealthCare.gov): For those above 138% FPL, marketplace plans are available with substantial subsidies. Record 292,994 enrolled in 2025, with 96% receiving subsidies averaging $593/month — net premiums average just $50/month. Enroll at HealthCare.gov.
OBH-Funded Community Programs: Louisiana’s Office of Behavioral Health funds treatment through regional human services authorities across all 64 parishes. Services include outpatient counseling, residential referrals, and MAT. Contact OBH at (225) 342-8952.
Free and Low-Cost Programs:
- Odyssey House Louisiana (New Orleans) — Residential and outpatient treatment, sliding scale
- Bridge House/Grace House (New Orleans) — Free 12-month residential programs
- Palmetto Addiction Recovery Center (Rayville) — Financial assistance available
- Salvation Army Adult Rehabilitation Centers (New Orleans, Shreveport) — Free residential programs
- Federally Qualified Health Centers — 30+ locations statewide offering sliding-scale services
Louisiana’s Polysubstance Crisis
Louisiana’s overdose landscape is defined by the intersection of multiple substances — understanding this pattern is critical for treatment planning:
Fentanyl: Officially attributed to 46% of deaths (the state’s lower attribution rate reflects coroner reporting practices rather than lower fentanyl presence — NMS Labs toxicology found 58.4% positivity). Fentanyl arrived later in Louisiana than in the Northeast, but penetration has accelerated rapidly.
Methamphetamine: Rising sharply across Louisiana, particularly in rural parishes. Approximately 70% of fentanyl deaths also involved methamphetamine or another substance. Meth is increasingly contaminated with fentanyl, creating overdose risk for stimulant users who may not knowingly use opioids.
Cocaine: Louisiana has a historically significant cocaine market, particularly in New Orleans and Baton Rouge. Cocaine-involved overdose deaths have increased as fentanyl contaminates the cocaine supply.
Prescription Opioids: While fentanyl has become the dominant opioid, prescription misuse remains relevant in Louisiana’s rural parishes where prescribing rates remain above national norms.
Treatment Implications: Louisiana’s polysubstance crisis means effective treatment must address multiple dependencies simultaneously. Programs offering integrated dual/triple diagnosis care — treating opioid, stimulant, and alcohol use disorders alongside mental health conditions — produce better outcomes than single-substance approaches.
Detox Costs in Louisiana
Medical detox costs in Louisiana vary by substance and level of supervision:
Alcohol Detox: $200-$600 per day ($1,400-$8,400 total for 7-14 days). Alcohol withdrawal carries seizure and delirium tremens risks requiring 24/7 monitoring. Multiple Louisiana hospitals and stand-alone facilities offer alcohol detox.
Opioid/Fentanyl Detox: $200-$500 per day ($1,400-$5,000 for 7-10 days). Medication-assisted withdrawal using Suboxone tapers is standard. Fentanyl detox may require extended timelines. Many programs transition patients directly to maintenance MAT.
Methamphetamine Detox: $150-$400 per day ($750-$2,800 for 5-7 days). Rising meth use in Louisiana makes this increasingly common. Withdrawal requires monitoring for depression, psychosis, and suicidal ideation.
Polysubstance Detox: $250-$700 per day ($2,000-$7,000 for 8-12 days). Given Louisiana’s polysubstance crisis, many patients require coordinated detox protocols for multiple substances simultaneously. This is more complex and costly than single-substance detox.
Benzodiazepine Detox: $250-$600 per day ($3,500-$8,400 for 14 days). Requires the longest taper protocols with seizure risk. Never attempt without medical supervision.
Louisiana Medicaid covers medical detox. For those with private insurance, detox is typically covered as part of inpatient treatment.
Medication-Assisted Treatment (MAT) Costs in Louisiana
Louisiana has invested significantly in expanding MOUD (medications for opioid use disorder) access. Monthly costs:
Suboxone (buprenorphine/naloxone):
- Without insurance: $300-$600/month (medication + provider visits)
- With insurance: $20-$150/month
- Generic versions reduce costs by 40-60%
Methadone:
- Without insurance: $250-$400/month (daily dosing + counseling)
- With Medicaid: Fully covered
- With private insurance: $50-$200/month
Vivitrol (naltrexone injection):
- Without insurance: $1,200-$1,500 per monthly injection
- With insurance: $0-$200/month
- Manufacturer patient assistance available
Oral Naltrexone:
- Without insurance: $50-$120/month
- With insurance: $10-$40/month
Louisiana’s Office of Behavioral Health has prioritized MOUD expansion through State Opioid Response grant funding, supporting hub-and-spoke treatment models, mobile MAT units, and telehealth prescribing to reach rural parishes. The state’s Medicaid SUD benefit explicitly covers all three FDA-approved medications for opioid use disorder.
Regional Treatment Markets
New Orleans Metro
The Greater New Orleans area has the highest concentration of facilities and the most complex treatment needs:
- ~75 facilities spanning all levels of care
- Odyssey House Louisiana and Bridge House/Grace House serve as community anchors
- University Medical Center New Orleans provides hospital-based detox and behavioral health
- Significant racial disparities in overdose rates and treatment access
- Tourism and hospitality economy creates unique triggers and barriers to recovery
Baton Rouge Metro
The state capital region has a growing treatment network:
- ~45 facilities including residential and outpatient options
- Our Lady of the Lake Regional Medical Center provides behavioral health services
- Baton Rouge Behavioral Hospital offers comprehensive psychiatric and SUD treatment
- Louisiana State University Health Sciences Center supports addiction medicine training
Shreveport/Northwest Louisiana
The I-20 corridor faces distinct challenges:
- ~30 facilities serving the tri-state (LA/TX/AR) border region
- Willis-Knighton Health System provides behavioral health services
- Proximity to Texas creates cross-state treatment dynamics
- Rising methamphetamine use alongside fentanyl
Rural Louisiana
Rural parishes face the most severe access gaps:
- Northeast Delta parishes (Madison, Tensas, Concordia) have minimal treatment infrastructure
- Acadiana/Southwest Louisiana has growing treatment options but still insufficient capacity
- Telehealth has expanded outpatient access but cannot replace residential treatment
- OBH regional authorities coordinate the limited safety net resources available
How Long Does Rehab Take in Louisiana?
Evidence-based treatment duration recommendations:
28-30 Day Programs: Standard insurance-approved length. Most common in Louisiana. Appropriate for individuals with less severe addiction and strong support.
60-Day Programs: Better outcomes for moderate to severe addiction. Given Louisiana’s polysubstance crisis, longer stays allow treatment of multiple dependencies.
90-Day Programs: Recommended for severe or long-term addiction, polysubstance use, or co-occurring disorders. Research shows 90+ days produces significantly better one-year outcomes.
Long-Term Residential (6-12 months): Bridge House/Grace House in New Orleans offers 12-month residential programs. Faith-based organizations provide additional long-term options. Particularly valuable for individuals with extensive treatment history.
Typical Louisiana treatment continuum:
- Medical detox (5-14 days)
- Inpatient/residential (28-90 days)
- Intensive outpatient IOP (8-12 weeks, 9-15 hours/week)
- Standard outpatient (3-6 months, 1-2 hours/week)
- Continuing care/aftercare (ongoing)
Louisiana Addiction Resources
Crisis and Referral Hotlines
- Louisiana 988 Helpline: 988 (call or text, 24/7) — Answered by VIA LINK (New Orleans) and LACG
- Louisiana 988 Chat: Louisiana988.org
- SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7)
- Louisiana OBH: (225) 342-8952 (treatment referrals and information)
State Agencies
- Louisiana Department of Health, Office of Behavioral Health: ldh.la.gov/office-of-behavioral-health — Licensing, provider directory, treatment funding
- Louisiana Opioid Data and Surveillance System (LODSS): lodss.ldh.la.gov — Real-time overdose surveillance data
- HealthCare.gov (Louisiana Marketplace): healthcare.gov — ACA insurance enrollment
- Louisiana Medicaid (Healthy Louisiana): healthy.la.gov — Medicaid application and eligibility
Recovery Support
- Alcoholics Anonymous (AA) Louisiana: 500+ meetings statewide, aa.org
- Narcotics Anonymous (NA) Louisiana: na.org
- SMART Recovery Louisiana: Science-based meetings in New Orleans and Baton Rouge
- Celebrate Recovery Louisiana: Faith-based recovery support statewide
- Louisiana Association of Drug Court Professionals: Treatment alternatives for justice-involved individuals
Final Thoughts: Getting Help in Louisiana
If you or someone you care about is struggling with addiction in Louisiana, the state’s 2016 Medicaid expansion means most low-income adults now have a coverage pathway to treatment — a transformation from the pre-expansion era. And the 35.2% decline in overdose deaths from 2023 to 2024 shows that expanded access is saving lives.
- Call 988 for 24/7 crisis support and treatment referrals — or chat at Louisiana988.org
- Verify your insurance — Most plans cover addiction treatment; use our calculator to estimate costs
- Check Medicaid eligibility — If you earn under 138% FPL, Louisiana Medicaid covers comprehensive treatment; apply at healthy.la.gov
- Explore marketplace options — 96% of Louisiana enrollees receive subsidies averaging $593/month; net premiums average $50/month
- Contact OBH at (225) 342-8952 for state-funded treatment referrals across all 64 parishes
- Consider medication-assisted treatment — MOUD significantly improves outcomes for opioid use disorder
- Don’t wait — Louisiana’s 35% decline in 2024 deaths shows treatment access is improving; early intervention produces the best results
Louisiana’s overdose rate remains among the highest in the nation, but the trajectory is finally turning. Help is available regardless of your financial situation.
Sources
- Louisiana Department of Health, Louisiana Opioid Data and Surveillance System (LODSS). lodss.ldh.la.gov
- Louisiana Department of Health, Office of Behavioral Health, HOPE Council Report 2023. ldh.la.gov
- Louisiana Department of Health, Office of Behavioral Health. ldh.la.gov
- SAMHSA Treatment Locator, Louisiana. Accessed February 2026. findtreatment.gov
- U.S. Census Bureau, American Community Survey, 2023. census.gov
- KFF Medicaid State Fact Sheet — Louisiana (May 2025). kff.org
- CMS, 2025 Marketplace Open Enrollment Period Report. cms.gov
- SAMHSA, National Survey of Substance Abuse Treatment Services (N-SSATS) 2022. samhsa.gov
- National Institute on Drug Abuse, Treatment Duration and Outcomes Research, 2024.
Your Plan May Not Cover Treatment in Louisiana.
Even with insurance, many people discover their plan doesn't cover residential treatment at the level they need. A broker who specializes in behavioral health coverage can review your situation and find a plan that works.
Call 1-866-454-9577Free Consultation · No Obligation
Prodest Insurance Group is a licensed, independent health insurance brokerage. Calling the number above connects you with a licensed insurance agent, not a treatment facility. Insurance placement is a separate service from treatment referral.
Louisiana Crisis Resources
Louisiana 988 Helpline: 988
Louisiana Department of Health (LDH), Office of Behavioral Health (OBH): https://ldh.la.gov/office-of-behavioral-health
SAMHSA National Helpline: 1-800-662-4357
Frequently Asked Questions
How much does rehab cost in Louisiana?
Inpatient rehab in Louisiana costs between $10,000 and $38,000 for a 30-day program without insurance. With PPO insurance, out-of-pocket costs typically range from $4,500 to $16,000 depending on your deductible, coinsurance, and out-of-pocket maximum. Louisiana's Southern cost of living keeps treatment pricing below the national average — even in New Orleans, where costs are at the higher end of the state's range. Baton Rouge, Shreveport, and Lafayette programs are generally more affordable.
How much is 28 days in rehab in Louisiana?
A 28-day inpatient rehab program in Louisiana costs approximately $9,300-$34,500 without insurance, based on daily rates of $330-$1,230. With PPO insurance, expect to pay $4,000-$15,000 out of pocket. The 28-day format is the most common residential program in Louisiana. While clinical evidence favors longer stays (60-90 days), most insurance plans initially authorize 28-30 days with extensions based on documented medical necessity.
Does insurance pay for addiction treatment in Louisiana?
Yes. All health insurance plans in Louisiana — including employer plans, ACA marketplace plans, and Medicaid — must cover substance use disorder treatment as an essential health benefit under the Affordable Care Act. Louisiana expanded Medicaid in 2016, covering adults up to 138% of the federal poverty level. Approximately 1.9 million Louisianians (about 1 in 4 nonelderly residents) are enrolled in Medicaid. The state enforces the federal Mental Health Parity and Addiction Equity Act.
How long is drug rehab in Louisiana?
The standard inpatient rehab stay in Louisiana is 28-30 days. The National Institute on Drug Abuse recommends at least 90 days for the best outcomes. Many Louisiana programs offer 30, 60, and 90-day options. After residential care, most individuals step down to intensive outpatient (8-12 weeks) and standard outpatient. The appropriate length depends on substance involved, severity, co-occurring mental health conditions, and treatment history.
How does a patient qualify for inpatient rehab in Louisiana?
Medical professionals determine inpatient rehab eligibility using ASAM (American Society of Addiction Medicine) criteria. You typically qualify if you have a severe substance use disorder, history of unsuccessful outpatient treatment, medical complications requiring 24/7 monitoring, co-occurring mental health conditions, unsafe home environment, or high risk of dangerous withdrawal. Insurance companies — including Louisiana Medicaid — use these same criteria when reviewing medical necessity for inpatient admission.
Does Louisiana Medicaid cover drug rehab?
Yes. Louisiana expanded Medicaid in July 2016, and approximately 1.9 million residents are enrolled — about 1 in 4 nonelderly Louisianians. Louisiana Medicaid covers comprehensive substance use disorder treatment including inpatient rehab, outpatient counseling, medical detox, and medications for opioid use disorder (MOUD) including buprenorphine, methadone, and naltrexone. The SUD Medicaid benefit covers residential treatment with minimal cost-sharing.
Are there free rehab programs in Louisiana?
Yes. Louisiana Medicaid covers addiction treatment for adults earning up to 138% FPL with minimal cost-sharing. The Office of Behavioral Health (OBH) funds community-based treatment programs across all 64 parishes through regional human services authorities. Federally qualified health centers offer sliding-scale addiction services. Faith-based programs like the Salvation Army and Odyssey House Louisiana provide free or low-cost residential treatment. The SAMHSA National Helpline (1-800-662-4357) and Louisiana 988 can connect you with options.
How much does detox cost in Louisiana?
Medical detox in Louisiana costs $150-$600 per day without insurance, with total costs ranging from $1,200 to $7,000 depending on the substance and length of stay. Alcohol detox (7-14 days) and opioid detox (7-10 days) are the most common types. With insurance, out-of-pocket costs are typically $400-$2,500. Louisiana Medicaid covers detox with minimal cost-sharing.
Why is Louisiana's overdose rate so high?
Louisiana's overdose rate of 52.6 per 100,000 — 62% above the national average — reflects multiple factors: deep poverty (Louisiana has one of the highest poverty rates nationally), geographic proximity to drug trafficking routes through the Gulf Coast and I-10/I-20 corridors, historical prescription opioid over-prescribing, a polysubstance crisis involving fentanyl, methamphetamine, and cocaine simultaneously, and racial health disparities. The 2,413 deaths in 2023 represented a 99% increase since 2018 and a 2.8x increase since 2013.
What happened with Louisiana overdose deaths in 2024?
Louisiana saw a dramatic 35.2% decline in overdose deaths from 2023 to 2024 — one of the largest single-year improvements in the nation. This decline from the state's 2023 peak of 2,413 deaths likely reflects expanded naloxone distribution (200,000+ doses and 100,000+ fentanyl test strips distributed between 2022-2024), expanded Medicaid-funded treatment access, increased MAT availability, and broader harm reduction infrastructure. However, Louisiana's rate remains well above the national average even with this improvement.
What is the payment option for rehab in Louisiana?
Payment options for rehab in Louisiana include: private insurance through employer or ACA marketplace (292,994 enrolled in 2025 with 96% receiving subsidies averaging $593/month), Louisiana Medicaid (1.9 million enrolled, covers comprehensive SUD treatment), self-pay with facility payment plans, OBH-funded community programs through regional authorities, sliding-scale fees at federally qualified health centers, and faith-based free programs. Because Louisiana expanded Medicaid, most low-income adults have a coverage pathway that doesn't exist in non-expansion states.
What types of rehab programs are available in Louisiana?
Louisiana offers a full continuum of addiction treatment: medical detox (5-14 days), inpatient/residential rehab (28-90 days), partial hospitalization or PHP (6+ structured hours daily), intensive outpatient or IOP (9-15 hours per week), standard outpatient therapy (1-2 sessions weekly), medication-assisted treatment (buprenorphine, methadone, naltrexone), and sober living. The state has 310 total facilities including 135 inpatient/residential programs.
What is the polydrug problem in Louisiana?
Louisiana's overdose crisis is distinctly polysubstance. While fentanyl is officially attributed to 46% of deaths, NMS Labs toxicology testing shows 58.4% fentanyl positivity among tested remains — the gap exists because many Louisiana coroners list 'polydrug toxicity' without naming a specific substance. Methamphetamine, cocaine, and fentanyl frequently appear together. Approximately 70% of fentanyl deaths in Louisiana also involved methamphetamine or another substance. This polysubstance pattern complicates treatment — programs must address multiple substance dependencies simultaneously.