How to find drug and alcohol treatment for an adult in California

This page covers finding and paying for treatment for adults. It is general information, not medical or legal advice. DNLH is not a treatment program or a crisis line.

Where do we start?

Start with the county. In California, people looking for substance use treatment are told to contact their county (DHCS). Every county has an access line. A trained screener asks about the person's needs and sends them to the right program.

San Mateo County. Call the BHRS Access Call Center at 1 (800) 686-0101, open 24/7 (TTY 711). BHRS offers detox, outpatient, residential and medication assisted treatment, based on each person's needs. Consultation, assessment and referrals are free. Treatment uses a sliding fee scale, and the county says no one is turned away for lack of funds. Pregnant and parenting women get priority admission (San Mateo County Health). You can call for someone you are worried about, not just for yourself (San Mateo County Health).

Santa Clara County. Call the Behavioral Health Call Center at (800) 704-0900, open 24/7 including holidays. Screeners refer callers to a site for a full assessment and can set up appointments for outpatient, residential and detox programs. The county says services are available for people with Medi-Cal, Medicare or no insurance (Santa Clara County). For treatment referrals in English or Spanish, the county also lists (408) 272-6518 (Santa Clara County).

Anywhere else in California. Find your county on the DHCS access line list. San Francisco's 24/7 access line is (888) 246-3333, and Alameda's is (844) 682-7215. You can also call DHCS's statewide referral line at (800) 879-2772 (DHCS).

Outside California. The SAMHSA National Helpline, 1-800-662-4357, is a free, confidential treatment referral line in English and Spanish, open 24/7 (SAMHSA).

What kinds of treatment are there?

The county screener helps match the person to the right level. San Mateo lists four main kinds (San Mateo County Health):

• Detox (withdrawal management). Help to stop safely, with medical support. Stopping heavy drinking suddenly can bring dangerous, even life threatening, withdrawal, so get medical help to plan it (NIAAA). Ask the screener about this.
• Outpatient. The person lives at home and goes to counseling and groups during the week. Intensive outpatient means more hours each week.
• Residential. The person lives at a treatment program for a while. This is for people who need more structure or a break from where they live.
• Medication assisted treatment. Medicine, together with counseling, for opioid or alcohol use. Ask the screener whether it fits the person.

After treatment, many people keep going to recovery support: groups, a sponsor, or a recovery coach.

How do we pay for it?

Medi-Cal. Medi-Cal covers substance use treatment through the county. If the person has Medi-Cal, the county access line is the way in. From January 1, 2027, some members (undocumented people, people with DACA or other PRUCOL status, and green card holders in the five year wait) move to Fee for Service Medi-Cal. DHCS says county substance use services continue for them (DHCS).

No papers, and no full Medi-Cal. Since January 1, 2026, undocumented adults 19 and older cannot newly enroll in full scope Medi-Cal (DHCS). Adults with DACA can still apply for full scope Medi-Cal (DHCS). Restricted scope Medi-Cal covers emergency, pregnancy and nursing home care (DHCS). Even so, call the county. San Mateo says no one is turned away for lack of funds, and Santa Clara serves people with no insurance. The county pages do not say whether every level of care is open to someone without full Medi-Cal, so ask on the call.

Pregnant? Pregnant people can apply for full Medi-Cal whatever their status (DHCS), and San Mateo gives pregnant and parenting women priority admission.

Big changes in 2027. Some groups now on state funded full scope Medi-Cal will move to pregnancy and emergency care only from July 1, 2027 (DHCS). If treatment is planned for then, ask the county how it will be paid. See Medi-Cal for adults in 2026.

Medicare. Santa Clara's call center serves Medicare members too (Santa Clara County).

What if they have insurance through work?

California law requires state regulated commercial health plans to cover medically necessary treatment of substance use disorders. Plans cannot limit it to short term or acute care (DMHC).

1. Call the member services number on the insurance card and ask for a substance use treatment provider.
2. If the plan says no, or cannot find a provider, file a complaint with the plan.
3. If that does not fix it, call the Department of Managed Health Care at 1-888-466-2219 (DMHC).

These rules cover plans the state regulates. Ask the plan who regulates it.

Will anyone find out?

Federal law gives substance use treatment records extra privacy. Under the updated rule, these records cannot be used to investigate or prosecute a patient without the patient's written consent or a court order, and a subpoena alone is not enough (HHS).

Worried about an immigration case? Getting treatment can matter at a green card medical exam, both for and against. Read Is it safe to get help for drug or alcohol use if I am an immigrant? and talk to an immigration attorney before that exam.

What do we say when we call?

You do not need perfect words. Have this ready:

• The person's name, age, city and county
• What they use, how much and how often, as best you know
• Whether they have had withdrawal symptoms before, like shaking, sweating or seizures
• Any health problems, medicines and pregnancy
• Their insurance or Medi-Cal card, or that they have none
• The language they prefer
• Whether they want help now

Then ask: "What level of care do you suggest? When is the first appointment? Is there a cost? What happens while we wait?"

Write down the name of the person you spoke with, the date and any appointment. The checklist has room for this.

What if they are not ready?

Adults choose their own treatment. You cannot sign an adult into a program. You can still help.

• Keep the door open. Tell them you love them and will help when they are ready. Avoid shaming or threats.
• Keep naloxone at home if they use opioids or pills that could contain fentanyl. You can buy it without a prescription (CDC).
• Learn about harm reduction. See What harm reduction means and how it can help someone you love.
• Get support for yourself. See Caring for a family member with mental illness without losing yourself.

If they talk about suicide, or you fear for their life, call or text 988, or chat at 988lifeline.org. It is free, confidential and open 24/7 (988 Lifeline). If someone is in immediate danger, call 911.

What happens while we wait for a bed?

Residential programs can have a wait. Ask the county:

• Can they start outpatient now while they wait?
• Can they start medication treatment now?
• Who do we call if things get worse before the bed opens?

Keep the person's phone number current with the program, and call back if you do not hear by the day they told you.

Questions families ask

Does the person have to call themselves? No. In San Mateo you can call for someone you are worried about (San Mateo County Health). The person will need to take part in the assessment.

Can we get help in our language? Ask on the call. The DHCS statewide referral line offers English or Spanish (DHCS).

Is a private rehab I found online better? Not always. Check that it is licensed and ask your county first. Many families pay little or nothing through the county.

They finished treatment and used again. What now? Call the county again. Going back to treatment is common, and it is not a reason to give up.

Who can help?

• San Mateo County BHRS Access Call Center: 1 (800) 686-0101, 24/7, TTY 711.
• Santa Clara County Behavioral Health Call Center: (800) 704-0900, 24/7. Referrals: (408) 272-6518.
• DHCS statewide referral line: (800) 879-2772.
• Every California county: DHCS access line list.
• SAMHSA National Helpline: 1-800-662-4357.
• DMHC Help Center (private plans): 1-888-466-2219.
• More: Who to call for crisis, abuse, shelter or drugs.

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

Is there a checklist I can print?