North Dakota has the fourth lowest total population and fourth lowest population density in the United States. It only has three cities with more than 50,000 people, which include Fargo, Bismarck, and Grand Forks. This sparse population means that the availability of both illicit drugs and rehab centers will be concentrated in these cities.

Treatment Centers in North Dakota

Some of the top rehabs in North Dakota are located in small towns. One of the reasons for this trend is that the large rural areas in North Dakota allow rehabs to provide in wilderness-based programs.

Summit Counseling Services (Williston)

Summit Counseling Services specializes in clients with substance abuse disorders resulting from mental trauma, especially sexual abuse and domestic violence. This North Dakota drug rehab also handles clients who have been referred by the judicial system.

Community Medical Services (Minot)

Community Medical Services provides treatment for opioid abuse, primarily detox.  This North Dakota inpatient drug rehab offers medical treatments with buprenorphine and naltrexone, including maintenance and relapse prevention programs.

Coal Country Substance Abuse Program (Beulah)

The Coal Country Substance Abuse Program provides outpatient treatment for substance abuse, including medical maintenance. It also offers a variety of therapies, including CBT, 12-step therapy and anger management.

North Dakota Substance Abuse and Addiction

A 2016 report from the Attorney General in North Dakota provides a comprehensive overview of the trends in substance abuse for that state. This report clearly shows that methamphetamine and heroin are areas of growing concern in North Dakota, as their use has jumped dramatically since 2010. Drug violations for heroin increased from four in 2010 to 177 in 2015, which is an increase of 4,300 percent. Methamphetamine violations more than quintupled during this period, increasing from 246 in 2010 to 1,633 in 2015.

Alcohol continues to be the most commonly abused substance by adults who receive treatment in North Dakota, although the number of adults admitted to rehab facilities for methamphetamines and heroin is growing much more rapidly. Methamphetamines accounted for 21 percent of admissions in 2012 and 39 percent in 2015, nearly doubling in three years.  Admissions for heroin increased from one to six percent during this period.

North Dakota Drug Statistics

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides statistics on drug use that are specific to North Dakota. About 31,860 North Dakotans admitted to at least one episode of binge drinking within the last month during 2016. Binge drinking is the consumption of at least five alcoholic drinks within a two-hour period for males and four drinks for females within a two-hour period. One alcoholic drink contains the amount of alcohol in 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor.

An estimated 2,370 North Dakotans were diagnosed with illicit drug use disorder in 2016, but only 320 of those received treatment. Illicit drug use generally includes the use of any illegal drugs or the use of prescription drugs that does not comply with a doctor’s orders.

The number North Dakotans requiring but not receiving treatment for alcohol use disorder was about 7,090 in 2016, although only 6,960 of those were actually diagnosed. About 8,690 North Dakotans were diagnosed with any type of substance use disorder, with about 570 of those receiving treatment. These substances include anything with a psychoactive effect, although they primarily consist of illicit drugs and alcohol.

North Dakota Drug Laws

North Dakota legalized the use of marijuana for medical purposes in 2017, ensuring that patients with a prescription for marijuana won’t be prosecuted. The final bill that was passed lacked some of the provisions that voters approved in 2016, such as the home cultivation of marijuana for patients who live more than 40 miles from a pharmacy. However, North Dakota still has some of the harshest laws in the United States for the non-medical use of marijuana. For example, possession of a single joint is punishable by a maximum sentence of one year and a fine of up to $2,000 for the first offense.

The punishments for possession of other controlled dangerous substances (CDSs) are also harsh. North Dakota laws classify these substances into five categories, or schedules, with Schedule I CDSs having the greatest potential for abuse. Simple possession of a Schedule I CDS like methamphetamine or heroin carries a maximum penalty of five years in prison and a $5,000 fine in North Dakota for the first offense.

Government Services

The Behavioral Health Division (BHD) of the Department of Human Services (DHS) administers treatments for substance abuse in North Dakota. It provides oversight over the planning, development, and implementation of systems that care for people affected by substance abuse and mental illness. The BHD provides behavioral health services directly through its eight regional centers in North Dakota. It also authorizes other agencies to perform these services, including the State Hospital and independent parties working under contracts.

The BHD uses Substance Use Disorder (SUD) vouchers to provide SUD treatment in North Dakota. The bill authorizing the funding for these vouchers was passed in 2016, which also assigned the BHD responsibility for developing and implementing the voucher system. SUD vouchers provide many SUD services, including the following:

North Dakota Treatment Programs

Treatment for SUD is generally divided into three phases, including detoxification, therapy, and aftercare.

The detoxification, or detox, phase eliminates the patient’s physical dependence on drugs. This phase usually involves the complete cessation of drug use, although it may be necessary to taper off in severe cases. Medical personnel may also provide medication to alleviate withdrawal symptoms. The detox phase can last up to seven days.

Therapy may be further classified into short-term and long-term programs. The duration of short-term programs is no more than 30 days and focuses on medical stabilization and learning the lifestyle changes that will be necessary to abstain from drugs. Long-term rehab programs typically last two to three months, although they may last as long as six months. These programs provide structured treatment plans that generally help the patient can recognize triggers and stop relapses.

Aftercare is generally performed on an outpatient basis, meaning the patient returns to the facility according to a pre-determined schedule. These sessions typically consist of some type of behavioral therapy, although they may also include education on healthcare, lifestyle changes, and personal relationships.

Types of Behavioral Therapy Options

Rehab programs generally involve some type of behavioral therapy in which patients learn to avoid using drugs. Rational Emotive Behavioral Therapy (REBT) and Cognitive-Behavioral Therapy (CBT) are two of the most common types of behavioral therapies currently in use for SUD.

REBT essentially trains patients to change their thinking in a way that will promote healthy behavior. It helps patients to rid themselves of negative behaviors and seek a happier, more fulfilling life. CBT was originally developed to prevent relapses of alcohol abuse, although it has since been adapted for the treatment of other types of SUD. This behavioral therapy is based on the theory that learning processes play a critical role in the development of maladaptive behavioral patterns like SUD. CBT shows patients how to apply various skills to identify and correct their problematic behavior.


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