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Condition Guide

Online Therapy for Substance Use & Addiction

Recovery is possible. Online therapy and telehealth programs make evidence-based addiction treatment more accessible than ever, from counseling to medication-assisted treatment.

Updated December 2025 9 min read
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Key Takeaways

Addiction is a medical condition, not a moral failing. Whether you're struggling with alcohol, opioids, cannabis, stimulants, or other substances, effective treatment exists—and you don't have to attend in-person rehab to access it. Online therapy and telehealth programs have expanded dramatically, making evidence-based addiction care available from home.

Who Online Substance Use Treatment Works For

Online treatment isn't for everyone at every stage. It works well for:

⚠️ When Higher Levels of Care Are Needed

Severe alcohol or benzodiazepine dependence can cause life-threatening withdrawal requiring medical supervision. If you experience tremors, seizures, or severe symptoms when not using, seek in-person medical care first. SAMHSA helpline: 1-800-662-4357 (free, 24/7).

Evidence-Based Approaches

Cognitive Behavioral Therapy (CBT)

Identifies triggers and develops coping strategies. Helps change thought patterns that lead to substance use. Strong evidence for alcohol and drug use disorders.

Motivational Interviewing (MI)

Explores ambivalence about change without judgment. Helps you find your own reasons for recovery. Often used in combination with other approaches.

Contingency Management

Uses positive incentives (rewards) for staying sober. Strong evidence especially for stimulant use disorders. Some online platforms incorporate this.

Medication-Assisted Treatment (MAT)

Combines FDA-approved medications with therapy. Available online for opioid use disorder (buprenorphine/Suboxone) and alcohol use disorder (naltrexone).

Medication-Assisted Treatment (MAT) Online

Since 2020, regulations have made it easier to prescribe addiction medications via telehealth. Several platforms now offer MAT online:

Medications Available via Telehealth

Opioid Use Disorder

  • • Buprenorphine (Suboxone, Sublocade)
  • • Naltrexone (Vivitrol)

Alcohol Use Disorder

  • • Naltrexone (oral or injectable)
  • • Acamprosate (Campral)
  • • Disulfiram (Antabuse)

Specialized Addiction Platforms

Several platforms focus specifically on substance use treatment:

Workit Health

MAT + Therapy

Online treatment for alcohol and opioid use disorders. Combines therapy with MAT. Accepts many insurances.

Monument

Alcohol Focus

Specializes in alcohol use disorder. Offers therapy, medication, and support groups. Founded by people in recovery.

Bicycle Health

Opioid Focus

Opioid use disorder treatment with Suboxone. Video visits with addiction medicine physicians. Insurance accepted.

Cerebral

General + Substance

Offers alcohol/substance use treatment alongside mental health care. Good for addressing co-occurring conditions.

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General Platforms with Addiction Counselors

Major online therapy platforms also have counselors who specialize in substance use:

BetterHelp

Filter for addiction/substance abuse specialists. Therapy only (no medication). Good for exploring your relationship with substances.

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Talkspace

Substance use counselors available. Can add psychiatry for medication management.

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Addressing Co-Occurring Conditions

Substance use rarely exists in isolation. Many people use substances to cope with underlying mental health conditions—a pattern sometimes called "self-medication." Effective treatment often needs to address both:

Online platforms like Cerebral and Brightside can treat both the substance use and underlying mental health conditions simultaneously.

The Bottom Line

Online therapy has made addiction treatment more accessible than ever. Whether you need counseling to explore your relationship with substances, evidence-based therapy to maintain recovery, or medication-assisted treatment for opioid or alcohol dependence, telehealth options exist.

Recovery is possible. The first step is reaching out—and that step is now easier than it's ever been.

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