Washington, D.C., has one of the most severe overdose crises in the country, and it doesn’t look like the national one. According to KFF’s analysis of CDC WONDER data, the District’s opioid overdose death rate in 2024 was 34.1 per 100,000 residents — the third highest in the nation, behind only West Virginia and Alaska.
There is better news inside that same data. Opioid overdose death rates fell in every state and in the District between 2023 and 2024, and D.C.’s rate is now within about 1% of where it stood in 2019, before the sharp pandemic-era rise. The crisis here is severe, and it is also receding.
If you’re looking for help in D.C. for yourself or someone you love, there is a real system here. The District operates its own behavioral health authority, its own Medicaid program with substance use disorder coverage and a same-day walk-in assessment center. This page lays out the hotlines, the local resources, how treatment gets paid for and where free and low-cost rehab exists in the District.
If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room. If you are in crisis or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988. The National Rehab Hotline at 866-210-1303 is for non-emergency information, support and referrals.
What Makes D.C.’s Overdose Crisis Different
D.C.’s opioid overdose crisis has a distinct age pattern. According to Live Long DC, the city’s opioid strategic plan, roughly 76% of fatal opioid overdoses in the District between 2016 and 2020 occurred among adults ages 40 to 69, with the highest concentration among people in their 50s. That figure covers a five-year window ending in 2020, but the pattern it describes has shaped how the District built its response.
That matters for anyone searching for help here. Older adults in long-term recovery, people managing chronic pain alongside substance use and people whose use predates the fentanyl era are all facing a drug supply that has changed underneath them. Fentanyl in the drug supply can make potency unpredictable, increasing overdose risk even for people with long histories of opioid use.
For some people with long-standing substance use, treatment may involve residential programs, recovery housing and medication for opioid use disorder rather than short detox alone. If fentanyl is part of the picture, that can affect what treatment needs to look like.
National Addiction and Crisis Resources
These lines are available to anyone in the District, 24/7:
- National Rehab Hotline. Free and confidential, 24/7. Get connected with information, guidance and referrals to substance use and mental health treatment resources in the D.C. area, including free and low-cost options. Non-emergency. 866-210-1303
- SAMHSA National Helpline. Free, confidential treatment referral and information service run by the federal government, available in English and Spanish, 24/7. 800-662-4357
- 988 Suicide & Crisis Lifeline. Free, confidential crisis support for anyone experiencing emotional distress, suicidal thoughts or a substance use crisis. Call or text 988.
- Veterans Crisis Line. Confidential crisis support for veterans, service members and their families, staffed by responders trained in military culture. Dial 988 then press 1, or text 838255.
- Crisis Text Line. Text-based crisis support for people in emotional distress who would rather not speak on the phone. Text HOME to 741741.
- NAMI HelpLine. Information, resource referrals and support for people affected by mental health conditions and their families. 800-950-6264, or text HELPLINE to 62640.
Washington, D.C., Addiction and Behavioral Health Resources
The District runs its own behavioral health system, which means D.C. residents have access to local entry points that don’t exist everywhere:
- DBH Access HelpLine. The District’s own 24/7 line connects residents to DBH-certified mental health and substance use treatment providers and can dispatch mobile crisis teams to people unable or unwilling to travel for care. 888-793-4357 (1-888-7WE-HELP)
- DBH Assessment and Referral Center (ARC). Same-day walk-in assessment for substance use treatment at 75 P Street NE, open Monday through Friday, 7:00 a.m. to 6:00 p.m. Arrive before 3:30 p.m. for same-day service. Staff conduct a full assessment covering use history, mental health needs and overall health, then match you to a certified provider. Free HIV testing is available to anyone seeking an assessment. 202-727-8473
- NAMI DC. The District chapter of the National Alliance on Mental Illness offers support, education and resource referrals for D.C. residents living with mental health conditions and co-occurring substance use. 202-546-0646
The ARC walk-in option is worth knowing about specifically. Most people searching for treatment expect a phone tree and a waiting list. A same-day, in-person assessment that ends with a referral to a certified provider offers a shorter path, and it’s free to District residents. If mental health is part of what’s going on, D.C.’s system is designed to treat both together rather than sending you to two places; our overview of mental health support covers why that matters.
How Treatment Gets Paid for in the District
Cost can be a major reason people in D.C. delay treatment. The District has Medicaid coverage for substance use disorder services and a locally funded behavioral health safety net.
- DC Medicaid. D.C. Medicaid covers eligible substance use disorder services, including residential treatment when medically appropriate.
- DC Healthcare Alliance. A locally funded program for low-income District residents who don’t qualify for Medicaid, including many who are ineligible because of immigration status.
- DBH-funded care. The Department of Behavioral Health can use local funds to reimburse certified substance use disorder providers for certain services that aren’t covered by Medicaid, or for clients who aren’t eligible for Medicaid.
- Private insurance. Federal parity protections generally require health plans that cover substance use disorder care to apply comparable limits to those used for medical and surgical care.
If you’re unsure which type of coverage applies to you, that’s a reasonable place to start. Sorting that out can help narrow down which treatment options may be available.
Free and Low-Cost Rehab in Washington, D.C.
Several District organizations provide substance use disorder services, including residential treatment, outpatient care and recovery support. Payment and eligibility vary by program, but some services may be available through Medicaid, government funding or income-based assistance.
Samaritan Inns
A nonprofit providing residential treatment and recovery support for adults affected by homelessness and substance use disorder. Samaritan Inns offers an intensive 28-day treatment program followed by longer-term transitional treatment and recovery support. Programming includes services for women with children.
Salvation Army Harbor Light Center
The Salvation Army Harbor Light program is a local substance use treatment resource offering residential and outpatient care as well as transitional housing. Payment options include Medicaid, government funding and self-pay. The program serves adults, including veterans, pregnant and postpartum women and people with co-occurring mental health and substance use conditions.
Regional Addiction Prevention (RAP), Inc.
Regional Addiction Prevention (RAP), Inc., is part of D.C.’s certified substance use disorder provider network and provides residential and outpatient services to District residents.
Community Health Centers
D.C. providers such as Family and Medical Counseling Service, SOME (So Others Might Eat) and Whitman-Walker Health are also part of the District’s substance use disorder service network. Community health centers can offer another starting point for people seeking behavioral health or substance use care outside a residential setting.
Waiting lists may affect access to some programs, particularly residential treatment. If you’re supporting someone else through this, our guidance for families and loved ones covers ways to help while also looking after your own well-being.
Find Help in Washington, D.C.
Knowing that resources exist and knowing which one applies to your situation are two different things. If you’re looking at D.C.’s options and aren’t sure where to start, whether you’re eligible for Medicaid, whether residential or outpatient treatment makes more sense or what to do while a bed opens up, that’s exactly the kind of question worth asking out loud.
Call the National Rehab Hotline at 866-210-1303 to be connected with information, guidance and referrals to treatment resources in the District. The line is free, confidential and available 24/7. You can also read more about what a substance abuse hotline does before you call.
Frequently Asked Questions
- Is there a free rehab hotline for Washington, D.C.?
Yes. The National Rehab Hotline at 866-210-1303 is free, confidential and available 24/7 to connect D.C. residents with treatment resources. The District also runs its own line, the DBH Access HelpLine at 888-793-4357, which connects residents directly to DBH-certified providers. - Can I get substance use treatment in D.C. without insurance?
Yes. The DC Healthcare Alliance covers low-income residents who don’t qualify for Medicaid, and the Department of Behavioral Health funds certain services through its certified provider network for residents without Medicaid coverage. Nonprofit programs such as Samaritan Inns and Salvation Army Harbor Light also provide residential care with funding options for eligible residents. - Where can I walk in for a substance use assessment in D.C.?
The DBH Assessment and Referral Center at 75 P Street NE takes same-day walk-ins Monday through Friday from 7:00 a.m. to 6:00 p.m. Arrive before 3:30 p.m. for same-day service. No appointment is required, and the assessment results in a referral to a certified treatment provider. - Does DC Medicaid cover drug and alcohol rehab?
Yes. DC Medicaid covers eligible substance use disorder services, including residential treatment when medically appropriate. Coverage depends on the services you need and your eligibility. - What should I do if someone is overdosing in D.C.?
Call 911 immediately. Administer naloxone if it’s available — D.C. distributes it free through the Department of Behavioral Health and participating pharmacies and community organizations. Stay with the person until help arrives. A hotline isn’t a substitute for emergency care. - Are calls to the National Rehab Hotline confidential?
Yes. Calls are free and confidential, and the line is open 24/7. It’s a non-emergency information and referral line. For immediate danger, call 911. For a mental health crisis, call or text 988. - Are there resources for veterans in the D.C. area?
Yes. The Veterans Crisis Line is reachable by dialing 988 and pressing 1, or by texting 838255. The Washington DC VA Medical Center provides substance use treatment to enrolled veterans, and Salvation Army Harbor Light serves veterans among its populations. Our veteran addiction hotline page covers treatment options specific to former service members.
If you’re ready to look at options in the District, call 866-210-1303 — free, confidential and available 24/7.