Is it safe to get help for drug or alcohol use if I am an immigrant?

This page explains whether treatment affects immigration. It is not legal or medical advice, and Do Not Lose Hope is not a clinic or a crisis line. To find a program, see How to find drug and alcohol treatment.

Will going to treatment hurt my immigration case?

Here is the honest answer. Getting treatment is not a crime. Federal law gives treatment records extra protection. And for a green card, treatment is often the way through a health problem, not the cause of one.

But immigration law does care about substance use. A doctor's finding that you have a drug use disorder can block a green card, even with no arrest. So the real risk usually comes from the use itself and from what you say at the green card medical exam or interview, not from the act of asking for help.

We know fear keeps many people from getting care. Please don't let it. Your health and your life come first. Then, with a lawyer, plan how to handle the immigration side.

What does immigration law say about drug and alcohol use?

Federal law says a person found to be a drug abuser or addict is inadmissible. That can block a green card or entry. A drug abuser or addict can also be deportable, even with a green card.

The doctors who do green card medical exams, called civil surgeons, follow CDC rules. Under those rules:

• Drugs on the federal controlled substance list. A substance use disorder of any severity is a "Class A" condition, which makes you inadmissible. Marijuana is on the federal list, even though it is legal for adults in California.
• Alcohol and other substances not on the list. A substance use disorder makes you inadmissible only if it comes with harmful behavior, now or likely to happen again. Without harmful behavior, it is "Class B," which is noted but does not make you inadmissible.
• Harmful behavior means things like seriously hurting yourself or others, or a serious threat to safety. The CDC names driving while intoxicated as an example.
• Occasional use is not a disorder. The CDC says admitting occasional use, or one positive drug test alone, does not make someone Class A. A diagnosis needs at least 2 of the 11 medical criteria.
• Prescriptions taken as prescribed are not a substance use disorder.

For citizenship, being a "habitual drunkard" can also block the good moral character you need.

What happens at the green card medical exam?

If you apply for a green card inside the U.S., you must see a civil surgeon. The exam results go to USCIS on Form I-693.

The civil surgeon must ask about your use of drugs, alcohol and prescription medicine, now and in the past. They may review police, school, work and medical records, and may ask family members. Drug testing is not routine for everyone, but the doctor can order it based on your history.

If the doctor is not sure, they can put off the decision for 3 to 6 months and order random drug tests on short notice.

Be truthful. Lying to get an immigration benefit can create a bigger problem than the one you are worried about. That is exactly why you should talk with a lawyer before the exam.

How can treatment help my case?

This is the hopeful part. Under the CDC rules, a person found inadmissible for a substance use disorder can overcome it by reaching remission.

• For drugs on the federal list: at least 12 months in a row without meeting the criteria for a disorder (except craving), and no use at all. This must be checked with at least four random lab tests over 12 months. People in remission are Class B, not inadmissible.
• For alcohol: at least 12 months in a row without meeting the criteria (except craving), and at least 12 months since any harmful behavior. Full abstinence is not required.
• Your 12 months can start before the exam if the civil surgeon can document your recovery. The CDC says the doctor can use information from family, therapists, support groups and treatment programs. For drugs on the list, there must also be at least one negative random test.
• Medication for opioid use disorder counts as treatment. The CDC says methadone or buprenorphine used to reach remission should not be treated as a controlled substance for this purpose.

So treatment records can become proof of your recovery. Keep copies.

Are my treatment records private?

Mostly yes, with strong federal protection.

• 42 CFR Part 2. Records from federally assisted substance use programs cannot be used to investigate or prosecute you without your written consent or a court order. A subpoena alone is not enough. Programs had to follow the updated rule by February 16, 2026.
• HIPAA. Health providers can share records with law enforcement only in limited cases, like a court order or a qualifying subpoena, or to prevent a serious and imminent threat.
• You choose who sees them. You can sign a form allowing someone, like your lawyer, to get your records. You can decide what is shared and for how long, and you can refuse to sign.
• You can complain. If you think a provider broke these rules, you can file a complaint with the U.S. Department of Health and Human Services online or in writing.

For the full picture, see Will my therapist share information with immigration? and Your rights in a drug or alcohol treatment program.

Does it matter how I pay for treatment?

The federal public charge rule changed on September 18, 2026, and now looks at each case as a whole. USCIS applies the new approach to green card applications filed on or after that date. Whether using Medi-Cal for treatment matters depends on your situation, and some groups, such as U visa, T visa and VAWA applicants, are exempt. See Will using benefits like CalFresh hurt my immigration case? and ask your lawyer.

What should I do now?

1. Get help if you need it. Your health and safety come first.
2. Keep a recovery file. Program letters, attendance, test results, support group records. See the checklist below.
3. Talk to an immigration attorney before a green card medical exam or interview, or if you have any drug or DUI arrest.
4. Answer truthfully on every form and at every exam.
5. Ask before you sign any release of your records.

Recovery is possible, and it can help your case too. You are not alone in this.

Who can help?

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

• SAMHSA National Helpline: 1-800-662-4357. Free, confidential treatment referral and information, 24/7, in English and Spanish.
• San Mateo County ACCESS Call Center (for San Mateo County residents): (800) 686-0101, TTY 711, 24/7. For residents with Medi-Cal or no insurance. Staff speak English, Spanish and Chinese, with free interpreters.
• Santa Clara County Behavioral Health Services Call Center (for Santa Clara County residents): 1-800-704-0900, 24/7.
• Other California counties: DHCS list of 24/7 substance use access lines. If you live outside California, the SAMHSA National Helpline can refer you.
• Community Legal Services in East Palo Alto (CLSEPA): 650-326-6440, for immigration legal help for people with low income in San Mateo and Santa Clara counties.
• More legal help: Free or low cost immigration legal help in the Bay Area

Is there a checklist I can print?

Healing takes time. You do not have to do it alone, and asking for help is a strong first step.