
Montana is a state with a lot of wide open spaces, sprawling forests, and a long border with Canada. All of these contribute to making marijuana the most widely-abused drug in the state, either grown locally or smuggled in from points north. However, the Drug Enforcement Administration (DEA) ranks methamphetamine as the primary drug threat in Montana, a perception backed up by admissions to Montana drug and alcohol treatment facilities. Meth admissions have quadrupled since 1995.

Substance Abuse and Mental Health Issues At-A-Glance, Montana
Substance Abuse and Mental Health Services Administration (SAMHSA), December 2008
Although Montana has fewer than a million people, its rates of alcohol drug abuse and dependency rank among the highest in the entire United States. This is doubtless fed but the fact that Montana also ranks in the top tier of states where citizens perceive low risk from using marijuana and tobacco. Not surprisingly, these “low-risk” substances have the highest rates of admission to rehabilitation centers in Montana.

Cocaine abuse is most prevalent on Montana’s Blackfoot Reservation and in the western half of the state. Tribal agencies own and manage four drug and alcohol treatment centers in Montana for the benefit of Native Americans caught in the addiction trap. The federal government owns 11 more. The remainder of the 57 drug and alcohol rehabilitation centers in Montana are private nonprofit or private for-private treatment centers. These are hardly exclusive as some might imagine. Eighty-four percent of all Montana rehab facilities receive public funding of some kind, making them widely available to citizens needing treatment for substance abuse in Montana.
As in most states, the majority of Montana treatment centers (95%) provide services on an outpatient basis. However, eight do offer residential care for those requiring more intensive recovery programs or medical care for debilitation caused by long-term abuse. Because these programs are relatively rare in the state, Montana residents should be prepared to look outside their local community to find the type of program best suited to their particular addiction problem.
Likewise, not all drug and alcohol treatment programs in Montana are created equal. Different facilities offer different approaches to treatment. Most use a combination of detoxification, counseling, behavior therapy, and ongoing support to get addicts sober and keep them from relapsing. A very small minority (7 programs) also offer opioid treatment programs using methadone or buprenorphine to manage opiate addictions. Just 11 doctors in the entire state of Montana were certified to administer buprenorphine as of 2006, so patients hoping for this sort of program may have to look farther afield.
Because rates of abuse and dependency among minors is so high, as shown below, Montana parents should educate themselves as to the signs and symptoms of substance abuse and be prepared to intervene at the first suspicion. National studies show that the majority of drug and alcohol dependencies begin with exposure in adolescence; better a juvenile trip to a Montana rehab center than a lifelong battle with substance abuse.

Substance Abuse and Mental Health Issues At-A-Glance, Montana
Substance Abuse and Mental Health Services Administration (SAMHSA), December 2008