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Complete Guide to Xanax (Alprazolam) Abuse and Addiction

Abuse of Xanax, technically known as alprazolam, has become an increasingly serious problem in the United States.

This prescription medication, commonly used by patients with various anxiety and panic disorders, has turned into one of the most commonly abused drugs due to the high that it can produce.

The euphoric high and sense of well-being the drug induces are very attractive to recreational users on its own. And when it's taken with other drugs like alcohol, cocaine, or prescription opioids like OxyContin, the high can become even more powerful – and deadly.

According to a report funded by SAMHSA (the Substance Abuse and Mental Health Services Administration), “The estimated number of alprazolam-related emergency department (ED) visits involving nonmedical use doubled from 57,419 visits in 2005 to 124,902 visits in 2010.”

And though emergency room visits involving the drug remained stable in 2011, America’s ever-growing addiction to opioids (a drug commonly abused alongside Xanax) is making abusing this dangerous medication deadlier than ever.  

The question, then, is how can Xanax abuse and addiction be prevented and proactively approached? What makes this drug so incredibly addictive? What are the dangers of it? And what goes into treating a substance use disorder like this when it actually develops?

Learn more about Xanax, its effects, and addiction treatment below.

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What Is Xanax & What Does It Do?

With so many teens and adults taking Xanax recreationally, its intended use may be unknown to some. So what is Xanax? And what does Xanax do?

Traditionally, Xanax comes in a pill, capsule, or liquid forms, and it is given to patients who suffer from anxiety or sleep disorders.

Medically known as alprazolam, Xanax belongs to the benzodiazepine drug family and is a prescribed CNS (central nervous system) depressant. These drugs tend to “calm” the brain down, so to speak. So for disorders that are caused by far too much activity in the brain (e.g., panic disorder, anxiety, insomnia), Xanax can help the brain return to normal functioning.

But let’s get more specific. All actions within the brain are driven by electrical activity within its neurons. Thoughts and feelings we all experience every day are all caused by a particular pattern of this electrical activity. And even reactions we aren't aware of like breathing and our heartbeat are driven by these surges of electricity.  

The brain uses two types of chemicals to control how our neurons transfer this electricity – excitatory and inhibitory chemicals called neurotransmitters. As the names suggest, excitatory neurotransmitters help certain neurons become more likely to generate an electrical burst. Inhibitory ones do the opposite and lower the electrical potential.

Disorders like insomnia, chronic anxiety, and panic disorder are linked with overactive neurons in the brain. What Xanax does is it increases the effectiveness of the brain’s main inhibitory neurotransmitter known as GABA (more technically known as gamma-aminobutyric acid). And that can help balance the brain’s level of excitement and, ultimately, help people with certain disorders feel more normal.

Of course, it gets a lot more technical than that. Have a look at the video below for a more detailed explanation of how Xanax works and what makes it so effective at treating a number of mood disorders.


With a proper prescription from a practicing doctor, Xanax is entirely legal. When used properly in a medical setting, it can be quite effective in treating different disorders.

However, while Xanax might be great for treating anxiety, insomnia, and panic disorders, its powerful effects come at a cost. When taken over time, it can cause patients to develop both a physical and psychological dependency.

And left unchecked, that dependency can lead to a crippling addiction to this potent medication.

Due to this potential for abuse and addiction, Xanax is classified as a Schedule IV substance on the Drug Enforcement Administration's list of controlled substances. Substances classified as Schedule IV have a lower potential or risk for abuse compared to other drugs, but using it improperly can still have devastating consequences.

Alprazolam looks different depending on the dosage. The 0.25mg Xanax dosage is oval shaped and white. The 0.50mg Xanax dosage looks similar but has an orange color. The next level up is a 1mg Xanax dose. These are the same oval shape but are blue color. Lastly, the 2mg Xanax pill.

This larger dosage is particularly popular among drug users. This is what is referred to as a Xannie Bar, ladder, or Xanax 2. This dosage is a long, rectangular, white pill. Generic Xanax pills may look different, so if you are in doubt, contact a healthcare professional.

It's important to note the size, shape, stamps, and dosages of pills. Drug dealers regularly counterfeit these drugs, and they have made a big business of selling these dangerous knock-offs. Some are laced with deadly opioids like fentanyl (one of the main contributors to the rising drug epidemic death toll). Others don't even contain alprazolam at all.

These imposters are only slightly different in their look. Drug dealers create them using pill presses to make their pills. And as a result, they look very legitimate. Sometimes, it may be necessary for a doctor, pharmacist, or law enforcement to see the difference between a counterfeit and real pill. They are experienced enough to catch the small mistakes drug dealers make.

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Many drugs being used illicitly today go by a variety of street names. And Xanax is no different. Some of the most common nicknames for this addictive medication include:

  • Bars
  • Benzos
  • Bicycle Parts
  • Blue Footballs
  • Bricks
  • Handlebars
  • Planks
  • School Bus
  • Upjohn
  • Xannies
  • Xanax 2
  • White Boys
  • White Girls
  • Yellow Boys
  • Z-Bars
  • Zanbars or Xanbars

Learning the names that Xanax is known by can help raise awareness and get conversations started regarding the dangers of the drug with your family - especially teenagers. Teens who use this drug will attempt to hide their addiction. They will use whatever terminology possible to ensure their abuse is not recognized by their loved ones. Knowing the terms can help you catch a possible drug abuse issue with your teen.

Xanax already has a strong name for itself, and over time, the street terms will change with each generation affected by its abuse. If you're not sure about street names, do an internet search of the terms.

A Closer Look At Xanax Drug Abuse

While alprazolam can be incredibly effective at treating a range of disorders, it’s also one of the most commonly abused drugs today. But how and why do people abuse Xanax in the first place?

As we've seen, Xanax is a powerful depressant that can essentially help calm the mind down. This can lead to increased feelings of tranquility, relaxation, and even a slight euphoria when taken at high levels. And this sense of relief from the anxiety of daily life can be quite alluring for some and can lead to alprazolam abuse.

Xanax is abused in a couple of ways in particular.

  • Oral Administration – The most common method of abuse is by taking Xanax orally in a way it was not intended to be used. Taking higher doses, swallowing pills more frequently than suggested, or even “parachuting” Xanax (crushing and swallowing the powder wrapped in thin paper for quicker release) are all forms of oral abuse.
  • Snorting – Some alprazolam abusers may also choose to get high from this drug by crushing and then snorting it. This typically results in a more intense high than taking it orally that often comes on much faster as well. However, since the drug bypasses the built-in filtration systems of the body (e.g., liver, kidneys), it can end up being much more toxic as well.
  • Injection – Injection is the quickest and deadliest way of administering Xanax. Users will typically crush up the pills, dissolve them in a solution like water, and then inject it directly into their veins. Doing so leads to an almost instantaneous effect and also leads to the most intense high of any of the other methods. But of course, it is also the most dangerous as well. Injection is also linked with the spread of bloodborne pathogens like hepatitis, human immunodeficiency virus (HIV), and viral hemorrhagic fevers.
  • Smoking – Some abusers may also crush up alprazolam and abuse it by smoking the powder. This is probably the least common form of abuse as smoking the medication can be especially harsh on the lungs.

In addition to these methods of administration, many people also tend to mix Xanax with other drugs like alcohol, other prescription drugs like painkillers, or illegal stimulants like crystal meth.

Doing so helps to intensify the desirable effects of these drugs. However, it can also make them exponentially more toxic as well, making the risk of overdose even higher than if Xanax was abused on its own.

According to NIDA, prescription drug abuse is on the rise across the country.

The Drug Abuse Warning Network (DAWN), a system designed to monitor emergency department (ED) visits in selected areas across the nation, showed that nonmedical prescription drug abuse is continuing to grow. "DAWN reported that more than 1.2 million ED visits in 2011 could be attributed to nonmedical use of prescription drugs; this represents about half (50.5 percent) of all ED visits related to drug misuse."

Xanax is just one more drug people misuse to get high. Currently, 85% of those who misuse central nervous system depressants and visit the ED are using Xanax. These staggering statistics illustrate issues the United States has with prescription drugs.

There are a variety of symptoms and side effects tied to taking Xanax. And when this drug is abused, these side effects can end up being even more severe. According to Drugs.com, the most common side effects are:

  • Absent, missed, or irregular menstrual periods
  • Decreased appetite
  • Decreased interest in sexual intercourse
  • Decreased sexual performance or desire abnormal ejaculation
  • Difficulty having a bowel movement (stool)
  • Inability to have or keep an erection
  • Increased appetite
  • Increased in sexual ability, desire, drive, or performance
  • Increased interest in sexual intercourse
  • Increased weight
  • Loss in sexual ability, desire, drive, or performance
  • Stopping of menstrual bleeding
  • Watering of the mouth
  • Weight loss

Most medical professionals tend to avoid prescribing benzodiazepines like Xanax in the long-term specifically because these drugs can cause very serious damage over time. And when they're actually abused for long stretches, they can be even more damaging.

This danger is made even more real by the fact that benzodiazepines tend to collect and accumulate in the body’s fatty tissue. As a result, continued use can end up compounding the detrimental effects of this drug.

According to the Center for Substance Abuse Research (CESAR), some of the most common long-term effects of abusing Xanax include:

  • Impaired thinking, memory, and judgment
  • Disorientation
  • Confusion
  • Slurred speech
  • Muscle weakness, lack of coordination

Professor Heather Ashton of The Institute of Neuroscience of Newcastle University states that the long-term effects of benzos like Xanax can end up being even more severe. Below are some of the most notable effects of taking these drugs for an extended period.

Emotional Blunting – Drugs like Xanax fundamentally alter the way the brain works on a chemical level. And as a result, the mind can become seriously thrown out of whack when these drugs are taken for too long. This can end up causing what’s known as emotional blunting or the inability to experience both pain and pleasure.

Aggravation of Mood Disorders – Some benzodiazepine abusers actually find that these drugs can end up making certain mood disorders like anxiety or insomnia even worse. This may be due to the increased tolerance that comes with taking these drugs long-term.

Paradoxical Stimulant Effects – Some people who take drugs like Xanax for a prolonged period end up experiencing new and more severe stimulant effects as a result of taking the drug.

In fact, Professor Ashton notes that some of her patients experienced a range of detrimental side effects over time such as:

  • Anxiety
  • Insomnia
  • Nightmares
  • Hallucinations
  • Irritability
  • Hyperactive or aggressive behavior
  • Exacerbation of seizures in epileptics
  • Attacks of rage and violent behavior including assault and even homicide

Brain Damage – Finally, drugs like Xanax can actually end up causing significant (and potentially permanent) brain damage in long-term users. As noted in Psychology Today, there have been multiple studies and respected doctors that have pointed out that long-term benzodiazepine use can lead to “worrying signs of brain atrophy” including “ventricular enlargement, widening of sulci, Sylvian and interhemispheric fissures.”

Opioids like heroin and prescription painkillers are the driving forces behind the drug overdose epidemic. However, they certainly aren’t the only culprits.

In fact, when it comes to overdosing on benzodiazepines, in particular, the culprits are often not benzos like Xanax alone.

In fact, NIDA found that over the course of 2002 to 2016, deaths from benzodiazepines alone stayed steady at around 500 to 1,000 deaths a year. However, deaths resulting from a combination of benzos and opioids rose from near 2,000 in 2002 to more than 8,000 in 2016.

What makes this combination so incredibly dangerous is the fact that both of these drugs are respiratory depressants that act on different systems throughout the body. And when they’re taken at the same time, their depressant effects tend to overlap – making the risk of respiratory failure substantially higher than if they’re taken on their own.

Anyone mixing Xanax with opioids or any other depressant or drug, in general, should stop doing so immediately. Combining these drugs can lead to deadly complications.

What Are the Symptoms of a Xanax Overdose?

One of the most terrifying effects of a Xanax abuse problem is the heightened risk of experiencing an overdose. An overdose occurs when the body can’t handle the level of toxicity of a drug. And it can end up having devastating – and potentially fatal – consequences.

Xanax Addiction

In fact, according to a study from the Journal of Pharmacy Practice, Xanax had one of the highest increases in death rates from 2003 to 2009 (233.8%), second only to oxycodone at 264.6%.

And like most life-threatening emergencies, time is a crucial factor when it comes to treating an overdose involving this drug. That’s why it’s so critical to know how to spot the signs of an alprazolam overdose before it’s too late.

According to Healthline.com, some symptoms to be on the lookout for include:

  • Confusion
  • Uncontrolled muscle movements
  • Poor coordination
  • Slurred speech
  • Tremors
  • Slow reflexes
  • Rapid heartbeat
  • Hallucinations
  • Seizures
  • Chest pain
  • Difficulty breathing
  • Abnormal heart rhythm
  • Coma

The Xanax half-life is about 12 hours, but that depends on the health of the individual and the dose. Extended-release pills may take upwards of 20 hours. Xanax dosage and Xanax half-life can be affected by other drug interactions and can affect the likelihood of Xanax overdose.

Added to that, there is an additional risk of overdose when it comes to street Xanax because many of these pills may actually be fake and laced with other deadly drugs or fillers.


If you recognize the signs above and suspect that you, a friend, or a loved one is going through a Xanax overdose, it’s critical to contact help right away. Do not wait. Do not reconsider. And do not hesitate.

Every wasted second is increasing the risk of permanent damage and even death.

There are two sources of help during an overdose to consider: Poison Control and Emergency Services.

  • Poison Control – This national helpline is available 24 hours a day, 7 days a week. It’s also a great resource in non-emergency times as well and can simply point you to information resources for the future. You can reach them at 1-800-222-1222.
  • Emergency Services (9-1-1)According to MedlinePlus, “if the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.”

Is Xanax an Addictive Drug?

To put it bluntly, yes. Xanax is highly addictive.  

People who abuse it regularly can quickly build up a serious tolerance to the drug and end up relying on it just to get through the day. It’s also important to remember that even when it’s used properly, Xanax can still lead to a dangerous physical and psychological dependency.

However, one of the most common misconceptions is that tolerance and addiction are the same things.

Tolerance is simply the body's resistance to a particular dose of the drug. The more you take, and the more frequently you take it, the higher the effective dose is going to be.  

Addiction, on the other hand, is defined by NIDA as “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control, and those changes may last a long time after a person has stopped taking drugs.”

Addiction, then, is more about destructive and compulsive behavior patterns. And in fact, an individual can actually end up being addictive without being physically dependent on a substance (and vice versa).

When it comes to Xanax, this drug tends to build up tolerance quite quickly, and the high it causes can end up causing serious destructive life patterns as well. To reiterate, then, Xanax is a highly addictive drug and should only be taken under the guidance of a medical professional.

And in fact, some people believe that Xanax may even be more addictive than heroin.


Like so many other drugs, the key component to why Xanax is so addictive has to do with how it interacts with the brain’s #1 pleasure chemical, dopamine.

Dopamine is what’s known as the “feel good” neurotransmitter. When you engage in a pleasurable activity like eating, exercising, accomplishing a goal, or having sex, one of the core sources of that pleasure is a release of dopamine.

On top of that, this chemical is also highly associated with learning – the more dopamine an action releases, the more the brain begins to crave it (this is the power of positive association). When dopamine is released naturally, it can cause a healthy drive to engage in activities that are essential to survival and success.

However, drugs like Xanax essentially hijack these systems so that the body produces dopamine without having to engage in these other naturally-fulfilling activities. And not only does that mean on-demand pleasure, but it also can end up releasing significantly more dopamine than these natural actions.

In fact, the National Institute on Drug Abuse (NIDA) found that addictive drugs can actually cause the release of ten times as much dopamine as natural activities. And that means that the brain’s drive to experience that again is unnaturally high.

And over time, these unbalanced levels of brain chemicals can actually change the structure and functioning of the brain as a whole. According to NIDA:

Brain-imaging studies from people addicted to drugs show physical changes in areas of the brain that are critical for judgment, decision making, learning, memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of an addicted person.

Addiction, then, is so hard to overcome because it is a physical brain disease, not a choice or some sort of moral failing.

The main people who are prescribed Xanax bars are those with anxiety disorders. This common mood disorder is one risk factor in developing a Xanax addiction. Those with mental health disorders are more likely than people without mental health disorders to experience a substance abuse disorder.

In fact, according to the National Institute on Drug Abuse (NIDA), “about half of people who experience a mental illness will also experience a substance use disorder at some point in their lives and vice versa.”

Having both of a substance use disorder and a mental health disorder like anxiety, depression, or schizophrenia (just to name a few) is what’s known as co-occurring disorders or dual diagnosis. And when it comes to recovery, these individuals need to be treated differently than people with just a substance addiction.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), "In many cases, people receive treatment for one disorder while the other disorder remains untreated. This may occur because both mental and substance use disorders can have biological, psychological, and social components. Other reasons may be inadequate provider training or screening, an overlap of symptoms, or that other health issues need to be addressed first. In any case, the consequences of undiagnosed, untreated, or undertreated co-occurring disorders can lead to a higher likelihood of experiencing homelessness, incarceration, medical illnesses, suicide, or even early death."

Along with the serious mental and physical side effects of an addiction to Xanax, there are plenty of other reasons for individuals to seek help if they’ve become addicted to this dangerous drug.

  • Social Effects – Addiction often alienates and isolates individuals from the friends and family members that they used to hold so dear. It can breed resentment, distrust, and eventually disdain. And while many people who recover from substance abuse are able to mend these relationships, some can end up being permanently destroyed.
  • Financial Effects – A drug habit is expensive. Whether addicts obtain their prescriptions by doctor shopping, stealing, or buying them on the streets, maintaining an alprazolam addiction can be quite costly. And when self-control has gone out the window, life-savings, college funds, and even rent and utilities are all at risk.
  • Behavioral Effects – One of the most devastating effects of addiction is the fact that once a substance of abuse has taken over a life, that person simply isn’t the same as they used to be. Maybe they begin compromising their morals for a fix. Or maybe they’re only able to feel happiness when using. Whatever the case is, addiction is all-encompassing. And for an addict, that means their freedom to choose how they want to live has to take a backseat to their drug use.

What Are The Symptoms of a Xanax Addiction?

Many addicts are unable to overcome their dependency problem on their own. On top of that, even more can’t even recognize that they have a problem at all. Waiting for them to actually ask for help, then, may not be the best strategy.

In fact, waiting for them to make the first move may actually be enabling their addiction, and it could end up making the problem even worse.

As such, recognizing whether or not a friend or a loved one is struggling with addiction is often the first step to helping them get the treatment that they need to recover. Below are some of the most notable signs of a drug addiction to watch out for.

And once these signs do become apparent, the next step is confronting the addict about getting help.

  • They generally become secretive, especially isolated, and unusually defensive about their Xanax use.
  • They seem to have an especially unpredictable mood. Be on the watch for erratic behavior or frequent emotional outbursts.
  • Money or valuables around the house start disappearing. A drug habit can be quite consuming and pricey, leading many users to start stealing or pawning off expensive property.
  • They seem to be going through severe weight fluctuations. This is especially true with Xanax as one of the major side effects of this drug is a loss of appetite.
  • As Xanax is a CNS depressant, lethargy and changes in sleep patterns may also indicate an alprazolam problem.
  • They no longer show interest in hobbies and passions that they used to enjoy. A Xanax addiction often leaves abusers feeling like the only thing that brings them joy is using.
  • They’ve been falling behind on responsibilities at home, work, or school. Whether it's forgetting to pick up the kids, missing appointments, or performing poorly on the job, there are plenty of responsibility-based signs that a Xanax addiction is to blame.  
  • Their general attitude has changed. This one is more of a “feel” than anything else. But if you notice your friend or loved one just isn’t quite the same as they used to be (a bit short with you, a bit more distant, or less loving), they may be struggling with an addiction to this powerful prescription drug.

What Is Xanax Withdrawal?

One of the best ways of spotting an addiction to Xanax is looking for symptoms of withdrawal once an individual has stopped taking it.

To explain, over the course of an addiction, the body ends up actually depending on a drug in order to function normally. Eventually, it even requires more and more of it to work properly. This is called building tolerance.

When that drug is suddenly taken away, however, the body has to adjust to life without it. And that can cause a host of uncomfortable side effects called withdrawal symptoms.  

For benzodiazepines like Xanax, these symptoms can end up being especially uncomfortable. In fact, withdrawals from drugs like alprazolam can actually be more excruciating than those associated with heroin, easily one of the most notoriously addictive drugs on the street today.

In fact, the drug addiction forum Bluelight.org conducted a survey asking which drug had the worst withdrawals. Over 14% of respondents said methadone, 13.6% said heroin, about 8% said other opioids, and around 5% said alcohol or methamphetamines. However, a whopping 38.49% of respondents said that benzodiazepines had the worst withdrawals.

Added to that, they’re one of the only drugs with withdrawals that can be directly life-threatening as well. And that means it’s all the more important to partner with a professional addiction facility when trying to get clean from Xanax.

According to Professor Heather Ashton in The Ashton Manual, some of the most notable withdrawal symptoms of benzos like Xanax include:

PSYCHOLOGICAL SYMPTOMS

  • Excitability (jumpiness, restlessness)
  • Insomnia, nightmares, other sleep disturbances
  • Increased anxiety, panic attacks
  • Agoraphobia, social phobia
  • Perceptual distortions
  • Depersonalization, derealization
  • Hallucinations, misperceptions
  • Depression
  • Obsessions
  • Paranoid thoughts
  • Rage, aggression, irritability
  • Poor memory and concentration
  • Intrusive memories
  • Craving (rare)

PHYSICAL SYMPTOMS

  • Headache
  • Pain/stiffness - (limbs, back, neck, teeth, jaw)
  • Tingling, numbness, altered sensation - (limbs, face, trunk)
  • Weakness ("jelly-legs")
  • Fatigue, influenza-like symptoms
  • Muscle twitches, jerks, tics, "electric shocks"
  • Tremor
  • Dizziness, lightheadedness, poor balance
  • Blurred/double vision, sore or dry eyes
  • Tinnitus
  • Hypersensitivity - (light, sound, touch, taste, smell)
  • Gastrointestinal symptoms - (nausea, vomiting, diarrhea,
  • constipation, pain, distension, difficulty swallowing)
  • Appetite/weight change
  • Dry mouth, metallic taste, unusual smell
  • Flushing/sweating/palpitations
  • Over-breathing
  • Urinary difficulties/menstrual difficulties
  • Skin rashes, itching
  • Fits (rare)

One aspect of withdrawal that’s relatively unique to benzodiazepines like Xanax is the fact that these drugs have withdrawal symptoms that can end up being directly life-threatening.

Now, it should be mentioned that improperly detoxifying from nearly all substances of abuse can lead to deadly complications. Malnutrition, dehydration, compromised immune systems and more are all quite common in many heavy drug users. And if they don’t receive medical assistance during their detox, these conditions can end up causing heart problems, respiratory failure, and other dangerous problems.

However, withdrawals from benzodiazepines like alprazolam can actually bring on potentially-fatal grand mal seizures. This has to do with the way this drug interacts with the brain’s inhibitory neurotransmitter GABA.

To explain, as an individual becomes physically addicted to Xanax, the body tries to rebalance itself by increasing the effectiveness of excitatory neurotransmitters to even things out. This is partly why tolerance to Xanax develops in the first place.

However, when alprazolam is abruptly removed from the system, GABA quickly returns to its normal potency while the excitatory chemicals stay overly powerful. And this disparity between the two types of neurotransmitters causes a flurry of electrical activity in the brain.

And as a result, the mind can be launched into a series of deadly seizures.

It’s this withdrawal symptom in particular that makes it so vital for Xanax addicts to seek out professional help rather than try to tackle their detox on their own.

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What to Do if You Know Someone Abusing Xanax

If you or someone close to you are abusing Xanax or have even developed a full-fledged addiction, it's time to seek out help. Addiction is a devastating disease, and without professional treatment, it can end up being impossible to kick the habit on your own.

Whether you’re looking for help staging an intervention, want to know more about what’s involved in treatment, or simply are looking for a professional assessment about your or a friend’s drug habits, Ashwood Recovery is here to help.

We offer expert guidance in overcoming and treating addictions of all types. And our clean, modern facility offers the best outpatient and intensive outpatient programs in the area. Plus, we’re nationally accredited by the Joint Commission – so you can be sure you’re only getting the highest level of care possible.

So, give us a call today, and we can help you start your recovery.

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