PCP is the one drug in its class with a diagnosis of its own. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders includes phencyclidine use disorder by name, alongside “other hallucinogen use disorder”, while carrying no separate diagnosis for most other psychedelic and dissociative drugs [1]. That is a small fact with a practical consequence: a clinician assessing PCP use has a recognized condition to work from.
This page covers when treatment helps, what the assessment weighs, whether withdrawal needs supervision, how the levels of care differ, the therapies with evidence, where medication fits, and cost. Our page on phencyclidine addiction covers the drug itself.
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental health crisis, call or text 988.
When PCP Use Becomes Something Treatment Can Help With
The diagnostic threshold is continued use despite negative consequences, and a person has to meet specific criteria for it [1]. That is the formal answer. Three practical patterns usually arrive first.
One is psychiatric. PCP has a history here that is worth knowing. Federal clinical guidance records that phencyclidine was briefly marketed as a human anesthetic and taken off the market because of an unusually high incidence of psychotic symptoms [2]. What people bring to an assessment is often that: confusion, paranoia or a break from reality that has not fully cleared.
Two is not knowing what was taken. The same federal guidance notes that PCP is frequently sold as LSD [2]. People arrive believing they took something else, which changes what an assessment should be looking for.
Three is everything around it. Alcohol, cannabis and stimulants are commonly in the picture, and often they are the part with the physical risk.
Assessment: What a Clinician Looks For Before Recommending a Level of Care
The assessment decides the level of care, and for this drug it leans heavily toward the mental state.
Six things get weighed. Whether psychotic symptoms are present now or have been. Whether they clear between episodes of use, or persist. What else is being taken, including things the person may not have chosen knowingly. Whether there has been agitation severe enough to involve other people or emergency services. Any personal or family history of psychosis. And what home can realistically hold.
Federal research guidance asks for a plan tailored to the person, addressing their own drug use patterns together with their drug-related medical, mental and social problems [3]. On a PCP page the mental half is usually the larger half.
Our rehab process page sets out where the assessment sits, and our levels of care guide covers what it chooses between.
Does PCP Need Medical Detox First?
Not usually on withdrawal grounds. Sometimes on psychiatric ones, which is a different reason to be in a supervised setting.
Federal research summaries describe the physical side effects of dissociative drugs, such as headache, nausea or changes in heart rate, as generally not life-threatening [1]. The same summaries attach a caveat to that sentence, and on a drug that is frequently sold as something else it cannot be left behind: illicitly manufactured or processed drugs may be contaminated with colorless and odorless fentanyl or other dangerous substances that can cause serious adverse events, including overdose and death [1]. There is no recognized physical withdrawal syndrome for PCP comparable to alcohol or opioid withdrawal.
What can require a clinical setting is the mental state. Given the psychotic symptoms that took this drug off the human market in the first place [2], somewhere with psychiatric cover is the right place to be if thinking is disordered, whatever the withdrawal question says.
Where alcohol or benzodiazepines are also in use, withdrawal becomes a medical procedure and the setting changes. Federal guidance sets out where that happens, from a physician’s office through freestanding programs and partial hospitalization to acute care inpatient units, aligned with the five adult detox levels used by the American Society of Addiction Medicine [4].
Detox is the opening step either way. Federal guidance states that detoxification is not substance abuse treatment and rehabilitation [5], and federal research guidance adds that detox alone generally leads back to drug use [3]. Our medical detox page covers the level of care, and our withdrawal symptoms page compares classes.
Where a PCP assessment can happen in Florida
Our campus at Umatilla, Florida, in Lake County northwest of Orlando, is The Recovery Village Umatilla. Medical detox, residential and inpatient care, inpatient rehab for mental health, a partial hospitalization program, outpatient care and aftercare planning all run from that one site, so a plan that starts at one level does not need a new provider to step down.
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The Recovery Village Umatilla is part of our family of treatment centers. See the Recovery Village Umatilla campus.
Residential Treatment for PCP Use, and Who It Suits
Residential care fits this drug more often than it fits the rest of its class, and the reason is psychiatric rather than chemical.
Three situations point to it. Psychotic symptoms that need daily clinical contact while they settle. A pattern of agitation that has become unsafe for the person or the people around them. Or a home that cannot absorb either of those while treatment runs.
A fourth is simply not knowing. Where somebody has been taking a drug sold as something else [2], a period in a setting where every symptom is observed is worth more than a weekly appointment.
Our inpatient rehab page describes what living at a program involves, and our guide to how long rehab takes covers the overall arc.
PHP and IOP for PCP Use
Once the acute mental state is stable, these two levels carry the work.
A partial hospitalization program fills most of a clinical day, with the person sleeping elsewhere. An intensive outpatient program is lighter, usually several blocks of a few hours a week, arranged around work or study.
For PCP the practical question between them is psychiatric review. Partial hospitalization usually means being seen by a prescriber often enough to adjust medication for a mental health condition week by week. Intensive outpatient care usually does not. Where antipsychotic or mood medication is being started or changed, that difference matters more than the hours do.
Our outpatient rehab page explains how those schedules are built.
Therapies With the Strongest Evidence for This Substance
No medication treats PCP use, so the therapy carries the plan.
Federal research guidance describes cognitive behavioral therapy as work that “seeks to help patients recognize, avoid, and cope with the situations in which they’re most likely to use drugs” [3]. It describes contingency management as positive reinforcement, in the form of rewards or privileges, for staying drug free and for attending and taking part in counseling [3]. It also notes that behavioral therapy helps people remain in treatment longer [3].
One addition is specific to this drug. Where psychotic symptoms have occurred, therapy has to be paced around them, and a program should be able to say plainly how it does that. Ask whether a psychiatrist is part of the team and how often they review.
Our pages on substance abuse counseling techniques and on what CBT is describe those sessions.
Medication Options, Where They Exist
Nothing is approved to treat PCP use itself. What gets prescribed is what sits around it, and on this page that is a substantial list.
Federal research guidance sets out which drug classes have a medication behind them, and this is not one of them; where a class has none, treatment consists of behavioral therapies [3].
The prescribing that does happen here is psychiatric. Where psychotic symptoms, severe anxiety, agitation or a mood disorder are present, those are treated on their own terms by a prescriber who has examined the person. Where opioids or alcohol are also in use, medication-assisted treatment may apply to those.
No amounts, schedules or drug choices appear on this page. Those decisions belong to the clinician in the room, not to a website.
Co-occurring Mental Health Conditions and Why They Change the Plan
For most substances this section is important. For PCP it is usually the whole plan.
Federal clinical guidance records the unusually high incidence of psychotic symptoms that ended this drug’s use as a human anesthetic [2]. Federal research summaries describe dissociative drugs as making people feel detached, with distorted vision and hearing [1]. Where any of that outlasts the drug, it is a condition to treat and not an after-effect to wait out.
Two things follow. Be specific on the assessment call about what has been happening mentally, including anything that sounds alarming to say. And expect the recommendation to move to a level with daily psychiatric contact if the answer warrants it.
Federal research guidance asks that a plan address mental and social problems alongside the drug use [3]. Our page on co-occurring conditions covers how the two are treated together.
Paying for PCP Treatment and Verifying Benefits
Six answers turn an estimate into a plan, and one phone call gets all six. Is the policy active. Is this campus in network for this exact policy. How much of the deductible and the out-of-pocket maximum is already met. Does the plan want authorization before care starts, and at which levels. How often does it review a continued stay. And what is the out-of-network position if it comes to that.
Underneath those answers sits a federal rule. Parity law forbids a plan that covers mental health and substance use benefits from attaching financial requirements or treatment limits to them tougher than the predominant ones it uses on substantially all medical and surgical benefits in the same classification [6]. It does not reach everyone. Non-federal governmental plans with more than 50 employees are covered, so are private employer group plans of that size, and so is coverage bought in the individual market [6]. Small-employer group plans are not, though non-grandfathered small-group and individual plans have to include this care as an essential health benefit under the Affordable Care Act [6]. Marketplace plans cannot put yearly or lifetime dollar limits on coverage of any essential health benefit, including mental health and substance use disorder services [7].
Our own what rehab costs page gives published ranges, $350 to $450 a day for partial hospitalization and $3,000 to $10,000 for thirty days of intensive outpatient care. They are our figures, not federal ones. Our insurance coverage guide expands the six questions, how to get into rehab covers what follows, and our nationwide directory of rehab facilities lists our campuses.
Frequently Asked Questions
Do I need inpatient treatment for PCP use? More often than for other drugs in this class, and for psychiatric rather than withdrawal reasons. Federal clinical guidance records the high incidence of psychotic symptoms that removed this drug from human medical use. Where thinking is disordered, where agitation has become unsafe, or where home cannot hold either, a bed is the right answer.
Is there a medication for PCP addiction? No. Federal research guidance sets out which drug classes have a medication behind them, and this is not one; where a class has none, treatment consists of behavioral therapies. Psychiatric medication is a different matter, and where psychosis, agitation or a mood disorder is present a prescriber treats those directly.
How long does PCP treatment take? It depends what is being treated alongside. For substance use, federal research guidance holds that most people need at least three months in treatment to significantly reduce or stop drug use, with better outcomes at longer durations. Where a psychiatric condition is also being managed, that condition sets its own timeline and it is usually the longer one.
Will insurance cover it? Generally yes to some degree, with the small print doing the rest. Where a policy includes this care, parity law will not let it carry harsher limits than the predominant ones covering substantially all that policy’s medical and surgical benefits. Marketplace plans cannot put yearly or lifetime dollar limits on coverage of any essential health benefit, including mental health and substance use disorder services. Get the verification done and get it in writing.
What happens on the first call? A screening. It is confidential and it binds you to nothing. The questions cover the substance and how often, anything else in use, earlier treatment, prescriptions, other diagnoses and the home situation. Raise any episode of confusion or paranoia without waiting to be asked, because it changes the recommendation. Benefits are usually checked in the same call; the clinical assessment is the step after.
Sources
- National Institute on Drug Abuse. Psychedelic and Dissociative Drugs. National Institutes of Health. https://nida.nih.gov/research-topics/psychedelic-dissociative-drugs
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment, Chapter 4: Physical Detoxification Services for Withdrawal From Specific Substances. Treatment Improvement Protocol (TIP) Series No. 45, SAMHSA, via NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK64116/
- National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction — Treatment and Recovery. National Institutes of Health. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment, Chapter 2: Settings, Levels of Care, and Patient Placement. Treatment Improvement Protocol (TIP) Series No. 45, SAMHSA, via NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK64109/
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment, Chapter 1: Overview, Essential Concepts, and Definitions in Detoxification. Treatment Improvement Protocol (TIP) Series No. 45, SAMHSA, via NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK64119/
- Centers for Medicare and Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA). https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity
- HealthCare.gov. Mental Health and Substance Abuse Health Coverage Options. Centers for Medicare and Medicaid Services. https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide, 3rd edition. National Institutes of Health. https://nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf
This page is for general information and is not medical advice. Only a licensed clinician who knows your history can tell you what is right for you. If you or someone you know is in immediate danger, call 911. For free, confidential support 24/7, call or text 988.
Author
Chief Medical Officer,
The Recovery Village
