Treatment
Cocaine and stimulant use disorder treatment with NYSHIP
NIDA reports that there are no FDA-approved medications to treat cocaine use disorder, but that many behavioral treatments have proven effective in both residential and outpatient settings. Most care therefore centers on therapy, often in outpatient or intensive outpatient programs.
Published by the NYSHIP.rehab editorial resource · Updated
Which behavioral therapies are used?
| Approach | Core idea | What to ask a program |
|---|---|---|
| Contingency management (CM) | Structured, tangible incentives for meeting goals such as negative drug tests | Do you offer CM, and how is it structured? |
| Cognitive-behavioral therapy (CBT) | Recognizing triggers, avoiding high-risk situations and building coping skills | Is CBT individual, group or both? |
| Community and residential approaches | Structured settings and supports for people who need more intensity | What would make you recommend a higher level of care? |
NIDA describes studies in which people receiving contingency management stayed abstinent longer than comparison groups. Ask whether a program uses these evidence-based methods rather than relying on general talk therapy alone.
What safety risks should families know about?
NIDA notes that cocaine adulterated with fentanyl and related substances is a major concern, and that combining cocaine with opioids is especially dangerous. Cocaine also affects the heart. Call 911 for chest pain, seizure, overheating or unresponsiveness. Because of fentanyl risk, some families also keep naloxone available (CDC naloxone information (opens in a new tab)).
Is a clinical assessment the same as insurance approval?
No. They are two separate steps. A clinical assessment is done by a qualified clinician, who recommends a level of care — for example outpatient therapy, intensive outpatient, residential care or medically managed withdrawal. Insurance certification is the Empire Plan MHSU Program's decision that a covered service is medically necessary under plan terms (PE and C-82 At A Glance, printed p. 11). Stimulant treatment rarely requires medically managed withdrawal, but the assessment should still screen for heart symptoms, sleep, mood and any other substance use.
| Clinical assessment | Plan certification | |
|---|---|---|
| Who decides | Your clinician or program | The MHSU Program (administered by Carelon) |
| Question answered | What care fits my health needs? | Will the plan pay benefits for this service? |
| What to keep | The written recommendation | Any reference number, approved dates and next review date |
How does Empire Plan coverage apply?
Therapy and outpatient programs fall under MHSU outpatient rules: network visits may carry a $25 copayment, and non-network care is paid at 80% of the allowed amount after the combined deductible (printed p. 12). See outpatient, PHP and IOP coverage and, if a residential program is recommended, inpatient rehab coverage.
Questions to ask a program
- Which evidence-based therapies do you use for stimulant use — CM, CBT or others?
- Do you screen for co-occurring depression, anxiety, ADHD or other substance use?
- Are you in The Empire Plan network for IOP or PHP specifically?
- How is a program day billed?
- What support continues after the program, such as outpatient therapy or peer groups?
Related guides
- CoverageOutpatient, PHP and IOP coverage under NYSHIPEmpire Plan coverage for outpatient rehab, PHP, IOP and virtual IOP: the $25 network copay, non-network 80% allowed amount and questions to ask.
- CoverageNYSHIP inpatient and residential rehab coverageHow Empire Plan inpatient and residential rehab coverage works: certification, network stays paid in full, non-network 10% of billed charges and what to ask.
- GuidesHow to help a loved one with NYSHIP coverage get treatmentPractical, respectful steps for families: how to talk about treatment, what Empire Plan information to gather, privacy limits, and when to seek emergency help.
- CostsHow much does rehab cost with NYSHIP?Estimate your Empire Plan rehab cost in five steps: network copays, the non-network deductible, coinsurance and balance billing.
Sources and source dates
- NIDA — Cocaine Research Report (research topic) (opens in a new tab) — Accessed October 17, 2026
- CDC — Reverse opioid overdose to prevent death (naloxone) (opens in a new tab) — Accessed October 17, 2026
- The Empire Plan At A Glance — Participating Employers (PE), January 2026 (opens in a new tab) — January 2026 (AAG-PE-1/26). Printed page(s) 12. New York State Department of Civil Service.
- The Empire Plan At A Glance — Council 82 (C-82), January 2026 (opens in a new tab) — January 2026 (AAG-C-82-1/26). Printed page(s) 12. New York State Department of Civil Service.
Plan guides are summaries and can change. Your Empire Plan Certificate and Certificate amendments control. This page is general education, not medical, legal or benefits advice. Read our editorial standards.