Pills that turned out to be fentanyl
Counterfeit Percocet, Xanax, or Adderall pressed with fentanyl are everywhere in the DC region. Many people we treat never intended to use fentanyl at all — they bought what they thought was a prescription pill.
Fentanyl treatment · Arlington, VA
Outpatient fentanyl treatment in Arlington, Virginia
Low-dose Suboxone induction built for fentanyl, Vivitrol, PHP and IOP, and overdose prevention — for adults in Arlington, Washington, DC, and Northern Virginia who need treatment that starts now.
- Low-dose induction protocols
- Day & evening IOP tracks
- Telehealth for Virginia residents only
Medically reviewed by the VABH Medical Team
When treatment helps
Fentanyl use patterns we treat
Fentanyl moves faster than any opioid before it — faster tolerance, faster withdrawal, and far less margin for error. Treatment has to move quickly too.
Withdrawal that hits within hours
Fentanyl leaves the bloodstream fast, so sickness arrives sooner and harder than with heroin or painkillers. Dosing every few hours just to stay level is a hallmark of fentanyl dependence.
Tolerance that climbed fast
Fentanyl is roughly 50 times more potent than heroin. Tolerance builds in weeks, not years, and the dose that worked last month does nothing today.
Overdose, Narcan, or a close call
A reversal, an ER visit, or a night someone had to keep you awake. The weeks after a nonfatal overdose are the highest-risk period there is — and the single best time to start medication.
Fentanyl plus xylazine ("tranq") or benzos
The regional supply increasingly carries xylazine and benzodiazepine analogs, which naloxone doesn't reverse and which complicate withdrawal. Skin wounds, prolonged sedation, and a rougher taper all point to a mixed supply.
Failed Suboxone starts
If you tried buprenorphine and went into sudden, severe withdrawal, that was precipitated withdrawal from fentanyl still in your system — not a sign the medication won't work for you. There is a protocol for this.
How we treat fentanyl use
Built around how fentanyl actually behaves
Protocols written for heroin and painkillers fail people using fentanyl. We use induction methods, dosing, and timelines designed for the drug that's actually in the supply.
Low-dose (micro-dose) Suboxone induction
Fentanyl stores in body fat and lingers for days, which is why standard inductions so often trigger precipitated withdrawal. Our medical staff may prescribe a low-dose induction protocol built for fentanyl — starting with tiny buprenorphine doses that climb gradually while you taper off — so you can transition with far less risk.
Buprenorphine maintenance
Once stabilized, buprenorphine stops withdrawal, blocks cravings, and cuts overdose death roughly in half. Fentanyl tolerance often means a higher maintenance dose than older guidelines assumed, and we dose to what actually works. There's no time limit on staying on it.
Vivitrol (extended-release naltrexone)
A monthly injection that blocks opioid receptors entirely, for people who are fully detoxed. Fentanyl's long tissue half-life means the opioid-free window before the first shot is longer than usual — we time it and coordinate it rather than leaving you guessing.
Detox & withdrawal management
High fentanyl tolerance, xylazine in the supply, or benzodiazepines in the mix often make supervised inpatient detox the safer first step. We place you with a vetted partner, coordinate the handoff, and hold your outpatient spot for the day you step down.
Overdose prevention & naloxone
Free naloxone (Narcan) and training for you and your family, fentanyl test strip guidance, and a blunt conversation about tolerance loss — the reason so many overdoses happen right after a break in use.
Dual-diagnosis therapy & relapse prevention
CBT, trauma-focused therapy, and structured group work for the depression, anxiety, PTSD, or chronic pain underneath the use — treated at the same time, by the same team.
Levels of care
Fentanyl treatment programs, from detox coordination to long-term MAT
Where you start depends on tolerance, what else is in the supply, and how stable home is. The assessment sorts that out — and you can step up or down later.
- 015 days/week · ~6 hrs/day
Partial Hospitalization Program (PHP)
Our most structured outpatient fentanyl treatment. Daily groups, individual therapy, and daily medical oversight through induction and stabilization while you sleep at home. Common directly after detox or a residential stay.
- 023–5 days/week · day or evening
Fentanyl Intensive Outpatient (IOP)
Several sessions a week with morning and evening tracks alongside ongoing buprenorphine or Vivitrol management — for people who are stabilized on medication and back at work.
- 03Weekly to monthly · ongoing
Office-based MAT & aftercare
Long-term medication management with counseling, drug screening, and alumni support. Many people stay on buprenorphine for years; with fentanyl in the supply, that's a survival strategy, not an unfinished treatment.
- 04When tolerance or risk is high
Medical detox (vetted partners)
Heavy daily fentanyl use, xylazine exposure, or polysubstance use with benzodiazepines or alcohol may call for supervised inpatient detox first. We coordinate placement and the return to outpatient care.
Across the river from Maryland
Convenient for Maryland commuters
Our Arlington center is a short drive from Montgomery County, Prince George's County, and the broader Maryland suburbs. Many clients choose in-person PHP and IOP here because the commute is manageable and the program fits around work. Telehealth is available for Virginia residents between in-person visits.
Common questions
Fentanyl treatment questions, answered
Why did Suboxone put me into withdrawal last time?
That's precipitated withdrawal. Fentanyl accumulates in fatty tissue and releases slowly, so buprenorphine can displace it from your receptors and trigger sudden, severe sickness even after a day or two without using. Low-dose induction protocols avoid this by starting at a fraction of a normal dose and building up while fentanyl clears.
How long does fentanyl withdrawal last?
Acute symptoms typically start within 8–24 hours and peak over 2–4 days, but fentanyl's tissue storage means fatigue, insomnia, and low mood can linger for weeks. Medication shortens the worst of it dramatically — most people don't need to white-knuckle any part of it.
Do I have to detox before starting treatment?
Not for buprenorphine — with a low-dose induction you can start while still using, under medical guidance. Vivitrol does require being fully opioid-free first, which takes longer with fentanyl. Our assessment tells you which route fits and whether supervised detox is safer.
What about xylazine (tranq) in the supply?
Xylazine isn't an opioid, so naloxone won't reverse its sedation and buprenorphine won't treat its withdrawal. If it's in your supply, we screen for it, manage the additional symptoms, and get wounds looked at — it changes the plan, and we'd rather know up front.
Does insurance cover fentanyl treatment?
Most major commercial plans cover outpatient opioid treatment, including PHP, IOP, and medication. Our admissions team verifies your benefits and gives you an expected cost before you commit. Self-pay options are available if you're uninsured.
Is treatment confidential?
Yes. Substance use records carry federal protection under 42 CFR Part 2 in addition to HIPAA — nothing goes to an employer, family member, or anyone else without your written consent.
Do you offer telehealth for fentanyl treatment?
Yes, for Virginia residents — our clinicians are licensed in Virginia, so telehealth sessions and buprenorphine management are available statewide. In-person care at our Arlington center is open to Virginia, Maryland, and Washington, DC residents.
In-person fentanyl treatment at 5400 Shawnee Road, Arlington, VA for VA, MD, and DC residents. Telehealth for Virginia residents only.
Get help today
Talk to someone who's done this before
Whether you're calling for yourself or for someone you love, the first conversation is free and completely confidential.
- Admissions — 24/7(571) 586-2883
- Location5400 Shawnee Road, Arlington, VA
Insurance accepted
Insurance coverage for fentanyl treatment
Fentanyl-focused outpatient care and Suboxone management are covered under the behavioral health portion of most plans — Anthem, CareFirst BlueCross BlueShield, Aetna, Cigna, UnitedHealthcare, Optum, Sentara Health Plans, UMR, and Johns Hopkins Health Plans. We verify benefits fast, because waiting is the dangerous part.
Don't see your plan? Call us — we also work with out-of-network benefits and self-pay.