The 2025 California Addiction Treatment Report

Executive Summary

Access to care remains the single greatest barrier for individuals and families facing a substance use disorder. Our 2025 analysis of all 1,141 licensed treatment facilities in California reveals a complex and deeply unequal landscape.

The data uncovers three critical and newsworthy findings:

1. A Massive Geographic Divide: Populous, affluent counties like Santa Clara (Silicon Valley) are "treatment deserts" with almost no facilities, while rural northern counties have the highest concentration of care.
2. A Crippling Medicaid Gap: Nearly 54% of facilities in the state do not accept Medicaid, creating an insurmountable financial barrier for California's most vulnerable residents.
3. A Systemic Failure for DUI Clients: A shocking 5.2% of facilities are equipped to serve DUI/DWI clients, signaling a major gap in the state's public safety and recovery infrastructure.

Geographic Disparities: The Silicon Valley "Treatment Desert"

The most striking finding of this report is the profound geographic inequality of care. Our analysis of counties with populations over 50,000 reveals that some of the state's most populous and affluent regions are "treatment deserts."

California's Treatment Deserts

Shockingly, Santa Clara County, the heart of Silicon Valley with a population of over 1.9 million, has one of the lowest rates of facilities in the state, at just 0.83 facilities per 100,000 residents. It is joined by other major counties like San Joaquin and Yolo in the bottom 5, forcing residents to travel long distances for care.

California's Treatment Oases

Conversely, care is heavily concentrated in smaller, more rural Northern California counties. Humboldt County has the highest concentration of facilities, with nearly 10 per 100,000 residents—more than 11 times the rate of Santa Clara County.

The Medicaid Gap: A Barrier to Entry

A critical finding of this report is the substantial gap in Medicaid coverage. Of all licensed facilities in California, only 529 (46.4%) are listed as accepting Medicaid. This means that for the state's most vulnerable residents who rely on public assistance, more than half of all treatment centers are financially inaccessible.

A Crisis of Specialized Care

Effective, modern treatment often requires specialized services. Our data shows concerning gaps in care for co-occurring mental health disorders, a critical need for holistic recovery. Less than half of all facilities (49.2%) are equipped to treat these complex cases.

Failure to Serve Vulnerable Populations

Access to affirming and culturally competent care is critical. The data reveals an alarming shortfall for clients in the justice system: a strikingly low 5.2% of facilities are listed as serving DUI/DWI clients.

Furthermore, less than half of all facilities offer programs for Adolescents (45%), Veterans (40.8%), or LGBTQ+ clients (49%).

The Payment Landscape

Financial barriers remain a primary obstacle to treatment. While a majority of facilities accept self-pay (84%) and private insurance (62.5%), only a third (31.5%) offer sliding scale fees, limiting options for many Californians.

Modern Care Trends: The Rise of Telehealth

A positive trend in the data is the significant adoption of telehealth. Over 71% of facilities in California now offer telehealth services. This critical development has the potential to bridge some of the geographic gaps identified in this report, connecting rural and underserved communities with care.