Substance Use Treatment · York, PA
No shame. No lectures. Real evidence-based care.
Substance Use Treatment in York, PA: Confidential, Judgment-Free Care
Ready to cut back or stop? Optimal Health York offers confidential substance use treatment in York, PA: a full psychiatric evaluation, FDA-approved medications such as buprenorphine and naltrexone for opioid and alcohol use disorders, and treatment for co-occurring depression or anxiety. Care is with board-certified psychiatric nurse practitioners, in person or by telehealth. Call (717) 202-2285.
Optimal Health York provides outpatient substance use treatment at 111 East Market Street in York, PA, and by telehealth. Board-certified psychiatric nurse practitioners offer evaluation, medications for alcohol and opioid use disorders such as buprenorphine and naltrexone, co-occurring mental health care, and referral to higher levels of care when needed. Call (717) 202-2285 or book online.
A medical condition. With evidence-based treatment.
Substance use disorders (SUDs) affect a remarkable share of the U.S. population. According to SAMHSA's 2024 National Survey on Drug Use and Health, 16.8% of Americans aged 12 or older — about 48.4 million people — met diagnostic criteria for a substance use disorder in the past year. Of those, 27.9 million had alcohol use disorder, 28.2 million had a drug use disorder, and 4.8 million had opioid use disorder. Yet only about 1 in 5 (19.3%) of people who needed substance use treatment received any — a treatment gap driven by stigma, cost, and a shortage of accessible providers.
Substance use rarely travels alone. 34.5% of U.S. adults with any mental illness also have a substance use disorder, and that figure rises to 47.3% among adults with serious mental illness. Among veterans, first responders, healthcare workers, and people living with chronic pain, depression, anxiety, PTSD, ADHD, or bipolar disorder, the overlap is even higher. Treating the substance use without treating the co-occurring condition — or vice versa — is one of the most common reasons treatment fails.
At Optimal Health York, board-certified Psychiatric Mental Health Nurse Practitioners (PMHNP-BC) provide judgment-free outpatient care grounded in the standards of the CDC and the American Society of Addiction Medicine: FDA-approved medications for opioid use disorder (buprenorphine, naltrexone) and alcohol use disorder (naltrexone, acamprosate, disulfiram), integrated treatment of co-occurring depression, anxiety, PTSD, ADHD, and bipolar disorder, behavioral support begun within your visits, and coordinated referrals to higher levels of care when intensive outpatient, residential, or methadone treatment is the right fit. We're an outpatient office-based practice — not a methadone clinic, intensive outpatient program, or residential facility — so part of our job is matching the level of care to what each person actually needs. New patient appointments are typically available within one week. We accept all major insurances. Call today to confirm your insurance. (717) 202-2285.
The 6 most common substance use disorders
Each substance has its own evidence-based treatment approach. Here are the substance use disorders we evaluate and treat at Optimal Health York, with the FDA-approved medications available for each.
| Disorder | U.S. prevalence | FDA-approved medications & approach |
|---|---|---|
| Alcohol Use Disorder (AUD) | 27.9M past-year (9.7%) | Naltrexone (oral or Vivitrol injection), acamprosate, disulfiram. Plus behavioral support, mutual-help group referral, co-occurring treatment. |
| Opioid Use Disorder (OUD) | 4.8M past-year (1.7%) | Buprenorphine (Suboxone, Subutex, Sublocade), naltrexone (Vivitrol). Methadone available only at federally certified Opioid Treatment Programs — we coordinate referral. |
| Tobacco / Nicotine Use Disorder | 37.8M current cigarette smokers | Varenicline (Chantix), bupropion (Zyban), nicotine replacement therapy (patch, gum, lozenge, inhaler). High success rate with combined approach. |
| Cannabis Use Disorder | Increasing with legalization | No FDA-approved medication. Treatment focuses on behavioral support, addressing co-occurring conditions, and motivational interviewing within visits, with referral to specialty therapy when needed. |
| Stimulant Use Disorder | Includes meth, cocaine, Rx misuse | No FDA-approved medication for primary use disorder. Treatment focuses on contingency management, behavioral therapy, treating co-occurring ADHD or depression. Specialty referral may be appropriate. |
| Sedative / Benzodiazepine Use Disorder | Common; under-recognized | No FDA-approved medication for primary use disorder. We help with safe gradual tapering (benzodiazepines have dangerous withdrawal) and treat the anxiety/insomnia/PTSD that often drives use, with non-controlled alternatives. |
Sources: SAMHSA 2024 NSDUH · CDC Opioid Use Disorder Treatment · ASAM National Practice Guideline · AAFP Opioid Use Disorder: Medical Treatment Options.
What a substance use disorder looks like
Per DSM-5, a substance use disorder is diagnosed by 11 specific criteria across four categories: impaired control, social impairment, risky use, and pharmacological criteria. Severity is rated as mild (2–3 criteria), moderate (4–5), or severe (6+) over a 12-month period.
Behavioral & social signs
- Using more, or longer, than intended — the "I'll just have one" that becomes five
- Repeated unsuccessful attempts to cut back or stop
- A lot of time spent obtaining, using, or recovering from the substance
- Cravings — strong urges to use
- Use causing problems at work, school, or home
- Continuing to use despite social or relationship problems caused by use
- Giving up important activities (work, hobbies, relationships) for use
- Using in physically dangerous situations — driving, operating equipment
- Continued use despite knowing it's causing physical or mental health problems
- Hiding use, lying about amount used, or feeling defensive about use
Physical & psychological signs
- Tolerance — needing more of the substance to get the same effect
- Withdrawal — physical or emotional symptoms when stopping or cutting back
- Sleep problems — insomnia, oversleeping, or disrupted sleep without use
- Appetite or weight changes
- Mood changes — irritability, anxiety, depression that worsen between uses
- Memory or concentration problems
- Frequent illnesses, injuries, or accidents
- Neglected hygiene or appearance
- Unexplained financial problems or borrowing money
- Increased isolation, loss of interest in formerly enjoyable activities
We use validated screening tools at evaluation: the AUDIT (Alcohol Use Disorders Identification Test) for alcohol, the DAST-10 (Drug Abuse Screening Test) for other substances, and the NIDA Quick Screen for general substance use. This page is not a diagnostic tool. If you're experiencing serious withdrawal symptoms (especially from alcohol or benzodiazepines, which can be life-threatening), seek emergency care immediately — call 911 or go to your nearest emergency room. If you or someone you know has overdosed, call 911 immediately and use naloxone (Narcan) if available. SAMHSA's National Helpline (free, confidential, 24/7): 1-800-662-HELP (4357).
The evidence-based treatment hierarchy
Substance use disorder is a medical condition with effective, FDA-approved treatments. The ASAM National Practice Guideline emphasizes medication for opioid and alcohol use disorders as a core part of care — not optional, not a last resort.
Comprehensive evaluation & level-of-care matching
The first step is a thorough 60-minute psychiatric and substance use evaluation. We assess which substances, severity (mild/moderate/severe per DSM-5), withdrawal risk, co-occurring psychiatric and medical conditions, social supports, and treatment history. Then we match the level of care to what's needed: outpatient office-based MAT (what we provide), intensive outpatient (IOP), partial hospitalization (PHP), residential, or methadone-based opioid treatment programs (OTPs). If a higher level of care is right, we coordinate the referral.
FDA-approved medications: opioid & alcohol use disorder
For opioid use disorder: buprenorphine (Suboxone, Subutex, Sublocade) is typically first-line in office-based outpatient treatment, with naltrexone (Vivitrol monthly injection) as another option after 7–10 opioid-free days. Methadone is an excellent option but available only at federally certified Opioid Treatment Programs — we refer when methadone is the right fit. For alcohol use disorder: naltrexone (oral or Vivitrol), acamprosate, and disulfiram are all FDA-approved options. Per the CDC, detoxification alone, without medication, is not recommended for OUD because of high relapse and overdose risk.
Treat co-occurring psychiatric conditions
Treating substance use without treating the conditions that often drive it is one of the most common reasons treatment fails. Per SAMHSA, 34.5% of adults with any mental illness also have a substance use disorder; among adults with serious mental illness, the number is 47.3%. We treat depression, anxiety, PTSD, ADHD, and bipolar disorder concurrently with the substance use disorder, using SSRIs, SNRIs, mood stabilizers, psychotherapy within your visits, and trauma-focused therapy referral as appropriate. Integrated treatment outperforms treating either condition alone.
Harm reduction, recovery support, and behavioral therapy
Recovery looks different for everyone. We talk openly about naloxone (Narcan) for anyone at risk of opioid overdose — we'll prescribe or help you obtain it — and provide harm-reduction education without judgment. Within your visits we use motivational interviewing and CBT-based relapse-prevention skills, with no separate therapy bill; we refer for contingency management, longer-form therapy, and mutual-help groups (AA, NA, SMART Recovery, Refuge Recovery) when those fit. Pharmacotherapy is most effective when combined with behavioral support, but the absence of behavioral support shouldn't delay or prevent medication treatment per ASAM. The goal is whatever works for the person in front of us.
In-person in York — or telehealth from home
Both options use the same providers and the same evidence-based treatment protocols. Pick whichever fits your week.
Common questions about substance use treatment
Is substance use treatment confidential?
Yes. Substance use treatment records are protected by especially strong federal confidentiality laws — 42 CFR Part 2, in addition to HIPAA — precisely because of how serious the consequences of disclosure can be. Your records can't be released to employers, family, courts, or law enforcement without your written consent or a court order, and even law enforcement requests require a special legal process.
Limited exceptions exist for medical emergencies, suspected child abuse/neglect reporting, and imminent danger to self or others. We discuss these clearly at your first visit so you know exactly what stays private and what doesn't.
Do you prescribe Suboxone (buprenorphine) for opioid use disorder?
Buprenorphine (Suboxone, Subutex, Sublocade) prescribing is determined case-by-case based on clinical fit, prescriber comfort, and what the patient needs. Since the X-waiver requirement was eliminated in 2023 by the Mainstreaming Addiction Treatment (MAT) Act, any prescriber with a standard DEA registration with Schedule III authority can prescribe buprenorphine for opioid use disorder — greatly expanding access nationwide.
If buprenorphine isn't a fit at our practice for your specific situation, we coordinate referral to a buprenorphine prescriber or Opioid Treatment Program. Call (717) 202-2285 to discuss your specific situation, or use SAMHSA's FindTreatment.gov to locate buprenorphine prescribers in your area.
What's the difference between buprenorphine, methadone, and naltrexone?
All three are FDA-approved for opioid use disorder, but they work differently:
Buprenorphine (Suboxone, Subutex, Sublocade) is a partial opioid agonist — it activates opioid receptors enough to prevent withdrawal and cravings, but with a "ceiling effect" that limits euphoria and overdose risk. Available in office-based outpatient settings.
Methadone is a full opioid agonist — highly effective, but per federal law can only be dispensed at federally certified Opioid Treatment Programs (OTPs) with daily supervised dosing, especially early in treatment.
Naltrexone (Vivitrol injection or oral) is an opioid antagonist — it blocks opioid effects entirely. Requires 7–10 opioid-free days before starting to avoid precipitated withdrawal. Can be prescribed by any clinician with prescribing authority. Per ASAM, the choice between these depends on patient preference, history, and treatment goals.
Can a psychiatric NP treat substance use disorders in Pennsylvania?
Yes. Psychiatric Mental Health Nurse Practitioners (PMHNP-BC) are licensed in Pennsylvania to evaluate substance use disorders, prescribe FDA-approved medications (naltrexone, acamprosate, disulfiram, varenicline, bupropion, buprenorphine when within scope) — working under Pennsylvania's collaborative-practice requirements for nurse practitioners — and treat co-occurring psychiatric conditions. Since the 2023 elimination of the X-waiver, any clinician with a standard DEA Schedule III authority can prescribe buprenorphine.
Both providers at Optimal Health York are board-certified PMHNPs. For patients who need intensive outpatient programs, residential treatment, or methadone, we coordinate referrals to specialty addiction treatment facilities in the York area and beyond.
Do I have to be sober to start treatment?
No. Coming in sober is not a requirement. In fact, that expectation has historically prevented millions of people from getting help. The first visit is an evaluation — we meet you where you are. For opioid use disorder, buprenorphine is typically started during mild-to-moderate withdrawal (induction); for alcohol use disorder, naltrexone or acamprosate can be started during current drinking.
What we ask: be honest with us about what you're using and how much, so we can plan safely. Withdrawal from alcohol and benzodiazepines can be life-threatening — if you're a heavy daily drinker or have been using benzodiazepines daily for a long time, do not stop abruptly without medical supervision. We'll plan a safe approach with you.
Do you treat both substance use and depression / anxiety / PTSD at the same time?
Yes — this is called integrated treatment for co-occurring disorders, and it's strongly supported by the evidence. Per SAMHSA, 34.5% of adults with any mental illness also have a substance use disorder, and 47.3% of adults with serious mental illness do. Treating one condition without the other often leads to relapse in both.
We treat depression, anxiety, PTSD, ADHD, and bipolar disorder concurrently with substance use disorder using evidence-based medications and psychotherapy begun within your visits. Depression details · Anxiety details · PTSD details · ADHD details.
Is substance use treatment covered by insurance?
Yes — substance use disorder treatment is covered under federal mental health parity laws (the Mental Health Parity and Addiction Equity Act, MHPAEA), meaning insurers must cover it on par with other medical conditions. We accept all major insurances. Call today to confirm your insurance. (717) 202-2285.
Most patients pay only their plan's specialist copay (typically $20–60). Self-pay rates are $249 for an initial evaluation and $99 for medication management follow-ups; behavioral support within your visit is not billed separately. Buprenorphine and Vivitrol have separate medication costs through your pharmacy.
Can I get substance use treatment via telehealth in PA, MD, or VA?
Yes — substance use disorder evaluation, medication management for alcohol use disorder (naltrexone, acamprosate, disulfiram), and follow-up care all work via telehealth. Buprenorphine prescribing via telehealth is permitted under current DEA telemedicine rules (the current flexibilities run through December 31, 2026) but may have specific requirements depending on the situation; we'll discuss this at intake.
You must be physically located in a state where your provider is licensed at the time of the visit. Abu Koroma sees patients in PA, MD, and VA (ages 12+); Zainab Koroma sees patients in PA and MD (ages 8+) including in-person at York. An initial in-person visit may be required for some controlled medications under federal rules.
What about naloxone (Narcan) — should I have it?
Yes, if you or anyone in your household uses opioids — whether prescribed or otherwise — you should have naloxone (Narcan). Naloxone reverses opioid overdose and can save a life. As of 2023, Narcan nasal spray is available over-the-counter at most pharmacies without a prescription.
We'll prescribe naloxone routinely for patients on buprenorphine or who are at any opioid overdose risk, and we'll talk through how to use it. Pennsylvania's standing order also allows pharmacists to dispense naloxone without an individual prescription. If you witness a suspected opioid overdose, call 911 immediately and use naloxone if available.
How soon can I be seen?
New patient appointments at Optimal Health York are typically available within one week. Initial substance use evaluations are 60-minute visits, allowing time for thorough history, screening, treatment matching, and care planning; follow-ups are 30 minutes. Same-day and next-day telehealth appointments are often available depending on provider schedule. Call (717) 202-2285 to check current availability, or book online 24/7 through our HIPAA-compliant patient portal.
If you're in immediate danger of overdose, severe withdrawal, or having thoughts of suicide, don't wait — call 911, go to your nearest emergency room, or call SAMHSA's National Helpline at 1-800-662-HELP (4357), available free 24/7. The 988 Suicide & Crisis Lifeline is also available.
Sources & references
- Substance Abuse and Mental Health Services Administration. Release of the 2024 National Survey on Drug Use and Health. SAMHSA 2024.
- SAMHSA. Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 NSDUH. 2024.
- Centers for Disease Control and Prevention. Opioid Use Disorder: Treating. CDC Overdose Prevention.
- American Society of Addiction Medicine. National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. ASAM, 2020 update.
- American Academy of Family Physicians. Opioid Use Disorder: Medical Treatment Options. Am Fam Physician, 2019.
- SAMHSA. FindTreatment.gov — Treatment Locator. National Helpline: 1-800-662-HELP (4357).
- SAMHSA. 2024 NSDUH National Releases.
Recovery starts with one honest conversation.
New patient appointments are typically available within a week. Confidential per federal law. Book online any time, or call during office hours and a real person will pick up.