The picture
Key Findings
1,130
Licensed facilities analyzed
SAMHSA-listed substance use treatment facilities in California
46.5%
Accept Medicaid
525 of 1,130 facilities
54%
Do not accept Medicaid
A financial barrier for the state's lowest-income residents
71.2%
Offer telehealth
A partial bridge across the state's geographic gaps
California's treatment system is large but deeply unequal. Access depends heavily on two things a person cannot change quickly: which county they live in, and whether their coverage is accepted where care exists. This report examines both, county by county and payer by payer.
Where care is and isn't
Geographic Disparities
The starkest finding is geographic. Silicon Valley's Santa Clara County is among the thinnest-served counties in the state per capita, while rural northern counties carry the highest concentration of care. Rates below are SAMHSA-listed facilities per 100,000 residents, limited to the state's 43 counties with more than 50,000 people so the per-capita math stays meaningful.
The five California counties (over 50,000 residents) with the fewest treatment facilities per capita.
| County | Population (2020) | Facilities | Per 100k residents |
|---|---|---|---|
| Tehama County | 65,829 | 0 | 0.00 |
| Yolo County | 216,403 | 2 | 0.92 |
| Santa Clara County | 1,936,259 | 18 | 0.93 |
| San Joaquin County | 779,233 | 9 | 1.15 |
| Sonoma County | 488,863 | 6 | 1.23 |
A rate near zero means a large population with almost no in-county facilities.
The five counties (over 50,000 residents) with the highest facility concentration per capita.
| County | Population (2020) | Facilities | Per 100k residents |
|---|---|---|---|
| Humboldt County | 136,463 | 13 | 9.53 |
| Mendocino County | 91,601 | 8 | 8.73 |
| Lake County | 68,163 | 5 | 7.34 |
| Marin County | 262,321 | 18 | 6.86 |
| Yuba County | 81,575 | 5 | 6.13 |
Rate is SAMHSA-listed facilities per 100,000 residents.
The gap runs deeper than facility counts. 13 California counties have treatment facilities but no detoxification service at any of them, and 4 counties have no facility at all. The most populous counties where a resident in acute withdrawal has no in-county detox option:
The most populous California counties whose facilities include no detoxification service.
| County | Population (2020) |
|---|---|
| Yolo County | 216,403 |
| Madera County | 156,255 |
| Napa County | 138,019 |
| Lake County | 68,163 |
| Tuolumne County | 55,620 |
Counties with at least one SAMHSA-listed facility, none of which reports the DT (detoxification) service code.
Coverage vs access
The Medicaid Gap
46.5%
Accept Medicaid
525 of 1,130 facilities
54%
Do not
Accessible only to the privately insured or self-paying
Fewer than half of California's facilities accept Medicaid, the coverage most low-income residents rely on. For a family without private insurance, a facility that does not take Medicaid is often not a longer wait, but no option at all. State-by-state acceptance is ranked in our Medicaid acceptance report.
What facilities offer
Levels of Care
36.8%
Offer detox
44%
Offer residential care
62.9%
Offer outpatient care
Outpatient care is the most common offering; medically supervised detox and residential beds, the services families most urgently picture, are available at a minority of facilities. That mismatch is why the first days of a treatment search are often the hardest: the nearest facility frequently exists but does not provide the level of care the moment requires.
Depth of services
Specialized Care
61.9%
Medication-assisted treatment
Methadone, buprenorphine, or naltrexone used in treatment
72%
Serve co-occurring disorders
Clients with both a mental health and a substance use disorder
83.7%
Trauma-related counseling
Most of California's facilities report serving clients with co-occurring mental health and substance use disorders, and a large majority offer trauma-related counseling. The narrower doorway is medication-assisted treatment: roughly 62 in 100 facilities use methadone, buprenorphine, or naltrexone, the treatments with the strongest evidence base for opioid use disorder.
Who is served
Vulnerable Populations
Share of California facilities reporting services for each population, from 1,130 facilities.
| Population | Facilities | Share |
|---|---|---|
| Teens & young adults | 610 | 54.0% |
| LGBTQ+ | 554 | 49.0% |
| Veterans | 461 | 40.8% |
| Pregnant women | 413 | 36.5% |
| DUI/DWI clients | 59 | 5.2% |
Categories are self-reported to SAMHSA and mirror the filters on our directory pages. The DUI/DWI figure signals a wide gap between the justice system's referrals and the facilities equipped to take them.
How care is paid for
Payment Landscape
62.6%
Take private insurance
84%
Accept self-pay
31.7%
Offer a sliding scale
Telehealth
Modern Trends
71.2%
Offer telehealth
Bridging geographic gaps for rural and underserved communities
Telehealth is the one lever that partially offsets California's geographic inequality: a majority of facilities now offer it, which can put an intake appointment within reach of a desert-county resident who could not otherwise drive to one.
How we counted
Methodology
Methodology, sources, and limitations
Source data. All figures are computed from the federal SAMHSA Behavioral Health Treatment Services Locator dataset (the dataset behind findtreatment.gov), for the 1,130 substance use treatment facilities listed in California. Figures were last recomputed on 2026-07-19.
Counting rules. Service and payment availability is determined by the SAMHSA codes each facility reports, using the same definitions as the filters on our directory pages (for example, medication- assisted treatment counts codes MU, BU, NU, and OTP). County assignment uses the U.S. Census Bureau's 2020 ZCTA-to-county relationship file, taking the county with the largest land-area overlap; populations are 2020 Census counts. The per-capita analysis is limited to counties with 50,000 or more residents so rates are not distorted by very small populations.
Limitations. Codes are self-reported and can lag reality. Counts are of facilities, not beds or capacity. Every facility-level fact can be independently checked on findtreatment.gov, and the full California listing is in our California facility directory.
Reuse
Cite This Report
Drug Rehabilitation Near Me, "The 2025 California Addiction Treatment Report" (updated 2026-07-19), computed from the SAMHSA Behavioral Health Treatment Services Locator dataset. https://www.drugrehabilitationnearme.com/reports/california-2025
Journalists and researchers are welcome to reuse any figure on this page with attribution and a link. For the underlying county-level data, a state table, or a quote, contact us through the site.