11,500+ verified treatment programs · Real Options, Real Recovery
Original research
Four in five addiction treatment facilities listed in SAMHSA’s national treatment locator do not report offering detoxification services. Across the 4,041 treatment communities we could measure, the median straight-line distance to a listed detox provider is 7.9 miles. But access is highly uneven: in 341 of those towns and cities, the nearest listed detox provider is more than fifty straight-line miles away.
An analysis of all 11,513 facilities in SAMHSA’s national treatment locator, measured against the 2,169 of 2,261 listed detox providers in that dataset that carry usable coordinates.
Research & analysis by Treatment Locators · Published September 2, 2026 · SAMHSA data retrieved August 16, 2026 · Analysis output generated 2026-09-02 · Methodology & citation
19.6%
Of SAMHSA-listed facilities report offering detox
2,261 of 11,513
7.9 mi
Median straight-line miles to a listed detox provider
Across the 4,041 measured treatment cities
996
Treatment cities over 25 straight-line miles from detox
24.6% of cities measured
341
Treatment cities over 50 straight-line miles from detox
8.4% of cities measured
Medically reviewed by Cole Timonere, PhD, JD, LMHC, LPCC · Reviewed August 16, 2026Key findings
For patients who require supervised withdrawal management, it can be an important first step before ongoing treatment. These are the four findings that hold up across every cut of the data.
19.6% of facilities
2,261 of 11,513 SAMHSA-listed facilities report offering detoxification. The remaining 9,252 facilities do not report a detoxification service in the SAMHSA data; they may report counseling, outpatient, medication, residential, or other treatment services. The dataset does not distinguish levels of withdrawal management, so the 2,261 may include ambulatory as well as inpatient detoxification.
A rural-urban split
Half of the 4,041 measured treatment cities sit within 7.9 straight-line miles of a listed detox provider. The gap is concentrated: 996 are beyond 25 miles and 341 are beyond 50. On this measure the pattern is one of uneven distribution rather than a uniform national shortage.
205.5 miles
In Alaska, the median treatment community is 205.5 straight-line miles from the nearest listed detox provider, against a national median of 7.9. Among states with at least 15 measured cities, Alaska has the highest share of remote communities: 72% of its measured treatment cities have no listed detox provider within 50 straight-line miles.
792.7 miles
Unalaska, AK has a SAMHSA-listed treatment facility and no listed detox provider within 792.7 straight-line miles. Straight-line distance across water understates the journey: there is no road route. Every one of the ten most isolated treatment communities in this dataset is in Alaska, where many of these routes are not drivable at all.
Interactive · 52 territories
Share of SAMHSA-listed facilities that report offering detox
Sharpest gaps · Detox share
Hover or tab any state to read its full profile. Northeastern states too small to shade are boxed beside the map.
Detox share
The distribution
The same 52 states and territories, ranked by four measures: what share of a state's SAMHSA-listed facilities report offering detox, and how far its treatment communities sit from the nearest listed detox provider in a straight line.
Percent of the state's SAMHSA-listed treatment facilities that report offering detoxification.
The same measure, at the other end of the distribution.
States with at least 15 measured treatment cities. National median is 7.9 miles.
Measured cities only; states with at least 15 measured treatment cities.
The far end
The national ranking is dominated by Alaska, so this view shows the single worst-served measured treatment community in each state and territory. Each has a SAMHSA-listed treatment facility but no listed detox provider within the straight-line distance shown; real travel distance is generally longer.
Data analysis · supply against burden
This comparison does not measure whether a state has sufficient detox capacity, which would require bed counts and admissions data this analysis does not contain. It provides a standardised way to compare listed detox-provider supply with the scale of recent overdose mortality, using CDC provisional counts for the most recent rolling 12-month period.
Each dot is a state. The diagonal marks the overall ratio for the states shown, 3.3 listed detox providers per 100 overdose deaths. States below the line have fewer listed detox providers per 100 overdose deaths than the U.S. overall; this describes relative supply, not whether capacity is sufficient. Both axes are logarithmic.
Hover or focus a state for detail.
Detoxification is the medical management of withdrawal. Withdrawal from alcohol and benzodiazepines can be medically dangerous, and some patients require supervised withdrawal management. Alcohol withdrawal can progress to seizures and to delirium tremens, a condition with meaningful mortality when it is not treated in a clinical setting.
Benzodiazepine withdrawal can also cause seizures and other serious complications, particularly after abrupt discontinuation in physically dependent patients.
Opioid withdrawal is rarely fatal in itself, but it carries a distinct danger: tolerance falls sharply during abstinence, so a return to a previously ordinary dose after an unsupervised withdrawal attempt is a common overdose scenario. Medications such as buprenorphine and methadone can reduce opioid withdrawal symptoms and cravings and, when continued as part of treatment, are associated with reduced overdose risk.
66,937 overdose deaths in the 12 months ending April 2026 sit on top of a network in which 2,810 of 4,111 treatment cities contain no SAMHSA-listed facility reporting detoxification services.
This is why distance is worth measuring. Long travel distances may contribute to delayed treatment, greater reliance on emergency departments, or attempts to manage withdrawal without nearby specialty services.
Source: CDC VSRR provisional counts · updated April 2026A visual summary of the timings and symptoms described in the written sections below. Select a phase to see the detail for that stage.
Alcohol · Peak
24–72 hours
Tremor, sweating, anxiety, nausea, insomnia, elevated heart rate
High. Alcohol withdrawal involves a rebound of excitatory nervous system activity after prolonged suppression of the brain's calming (GABA) signaling, which is why seizures and delirium tremens are documented complications rather than rare edge cases. Alcohol withdrawal is generally managed under medical supervision for heavy or long-term drinkers, and a history of prior severe withdrawal is specifically associated with a higher risk of another severe episode.
The clinical statements in this section summarise published federal guidance. They are not findings of this analysis, and Treatment Locators did not conduct clinical research.
Medically reviewed by Cole Timonere, PhD, JD, LMHC, LPCC
Licensed mental health and clinical counselor with doctoral and legal training, specializing in substance use disorders, withdrawal management, and behavioral health care. Reviews the clinical accuracy of the treatment guides on this site.
Editorial content — always confirm clinical details with a licensed provider.
The full dataset
Sort by any column. Each state name links through to its full facility directory.
Full dataset
| # | ||||||
|---|---|---|---|---|---|---|
| 1 | AlaskaAK | 64 | 5 | 7.8% | 205.5 mi | 1872% |
| 2 | IowaIA | 189 | 15 | 7.9% | 28.2 mi | 1719.1% |
| 3 | MontanaMT | 73 | 6 | 8.2% | 75.6 mi | 2064.5% |
| 4 | HawaiiHI | 81 | 7 | 8.6% | 12.3 mi | 834.8% |
| 5 | MinnesotaMN | 319 | 28 | 8.8% | 16.7 mi | 1212.9% |
| 6 | OregonOR | 178 | 16 | 9% | 19.7 mi | 2136.8% |
| 7 | WashingtonWA | 254 | 25 | 9.8% | 8.7 mi | 1921.8% |
| 8 | IdahoID | 105 | 11 | 10.5% | 20.7 mi | 619.4% |
| 9 | District of ColumbiaDC | 27 | 3 | 11.1% | 0 mi | 00% |
| 10 | MaineME | 115 | 13 | 11.3% | 14.3 mi | 614.3% |
| 11 | South DakotaSD | 39 | 5 | 12.8% | 27.9 mi | 426.7% |
| 12 | WisconsinWI | 205 | 27 | 13.2% | 25.4 mi | 1112.5% |
| 13 | DelawareDE | 37 | 5 | 13.5% | 6.4 mi | 00% |
| 14 | MissouriMO | 245 | 33 | 13.5% | 24.5 mi | 54.7% |
| 15 | ConnecticutCT | 153 | 21 | 13.7% | 4.6 mi | 00% |
| 16 | ArkansasAR | 109 | 15 | 13.8% | 31.4 mi | 815.7% |
| 17 | ColoradoCO | 232 | 32 | 13.8% | 17.6 mi | 1825.7% |
| 18 | NebraskaNE | 108 | 15 | 13.9% | 28.3 mi | 617.6% |
| 19 | KansasKS | 135 | 19 | 14.1% | 30.1 mi | 2232.4% |
| 20 | New JerseyNJ | 319 | 45 | 14.1% | 3.7 mi | 00% |
| 21 | OklahomaOK | 128 | 18 | 14.1% | 26.5 mi | 1420.6% |
| 22 | IllinoisIL | 515 | 76 | 14.8% | 5.5 mi | 63.3% |
| 23 | KentuckyKY | 375 | 56 | 14.9% | 15.5 mi | 21.6% |
| 24 | MassachusettsMA | 312 | 47 | 15.1% | 3.3 mi | 00% |
| 25 | North DakotaND | 59 | 9 | 15.3% | 30.6 mi | 637.5% |
| 26 | TennesseeTN | 302 | 49 | 16.2% | 20.9 mi | 21.9% |
| 27 | North CarolinaNC | 414 | 70 | 16.9% | 9.8 mi | 43.1% |
| 28 | New YorkNY | 595 | 102 | 17.1% | 6.9 mi | 116.3% |
| 29 | AlabamaAL | 107 | 19 | 17.8% | 24.7 mi | 48% |
| 30 | ArizonaAZ | 389 | 70 | 18% | 11.8 mi | 1320.3% |
| 31 | PennsylvaniaPA | 465 | 87 | 18.7% | 5.3 mi | 63.1% |
| 32 | VirginiaVA | 229 | 43 | 18.8% | 12.6 mi | 00% |
| 33 | IndianaIN | 373 | 72 | 19.3% | 12.1 mi | 00% |
| 34 | South CarolinaSC | 93 | 18 | 19.4% | 20.4 mi | 00% |
| 35 | MississippiMS | 88 | 18 | 20.5% | 21.5 mi | 00% |
| 36 | VermontVT | 46 | 10 | 21.7% | 0.8 mi | 15% |
| 37 | WyomingWY | 46 | 10 | 21.7% | 52 mi | 1655.2% |
| 38 | MichiganMI | 333 | 74 | 22.2% | 4.7 mi | 75.9% |
| 39 | MarylandMD | 392 | 88 | 22.4% | 1 mi | 00% |
| 40 | UtahUT | 224 | 52 | 23.2% | 2.8 mi | 1118.6% |
| 41 | New HampshireNH | 68 | 16 | 23.5% | 4.4 mi | 00% |
| 42 | Puerto RicoPR | 51 | 12 | 23.5% | 7.3 mi | 00% |
| 43 | GeorgiaGA | 238 | 61 | 25.6% | 5.9 mi | 00% |
| 44 | New MexicoNM | 107 | 28 | 26.2% | 28 mi | 1329.5% |
| 45 | NevadaNV | 74 | 20 | 27% | 26.5 mi | 320% |
| 46 | OhioOH | 460 | 129 | 28% | 3.8 mi | 00% |
| 47 | TexasTX | 399 | 113 | 28.3% | 2.9 mi | 1510.7% |
| 48 | West VirginiaWV | 118 | 34 | 28.8% | 8.9 mi | 00% |
| 49 | FloridaFL | 471 | 143 | 30.4% | 0 mi | 00% |
| 50 | LouisianaLA | 160 | 49 | 30.6% | 5.5 mi | 00% |
| 51 | Rhode IslandRI | 39 | 12 | 30.8% | 2.6 mi | 00% |
| 52 | CaliforniaCA | 856 | 310 | 36.2% | 0 mi | 62.2% |
SAMHSA national treatment locator · CDC VSRR provisional counts
Every substance use treatment facility in the national treatment locator export published by the Substance Abuse and Mental Health Services Administration (SAMHSA), 11,513 facilities in total, retrieved August 16, 2026. A facility counts as reporting detox when its SAMHSA service codes include a detoxification service. We did not independently verify licensing status, and this analysis is not endorsed by or affiliated with SAMHSA.
2,169 of the 2,261 listed detox facilities carry usable coordinates. For every city with at least one listed facility we measured the great-circle (straight-line) distance from its facility centroid to the nearest of those detox providers anywhere in the dataset; state and county lines are ignored, so the nearest provider may be in another state. No road distance or travel time was calculated. Thresholds and medians are computed on full-precision distances.
Overdose figures are pulled directly from the CDC's provisional VSRR series (12 month-ending counts) and refresh as the federal release updates, currently 66,937 deaths for the 12 months ending April 2026. They are never edited by us.
Straight-line distance generally understates real-world travel distance and, where no direct drivable route exists — as with the island and roadless communities that dominate the Alaska figures — it can substantially understate the practical travel burden. Travel time was not modelled.
This analysis counts listed facilities that report detoxification as a service. It does not measure detox beds, bed availability, capacity, occupancy or admissions. A facility appearing here does not mean a detox bed is available, that a given insurer is accepted, or that anyone can be admitted today.
A state whose locator listing includes large numbers of small outpatient counselling offices will show a lower detox share without necessarily having fewer detox providers. Distance measures are more comparable across states than percentage share.
Service codes are supplied by facilities to SAMHSA and are not independently audited by SAMHSA or by us. Every statement on this page describes what facilities report, not verified delivery of care.
Provisional overdose figures are revised as death certificates and toxicology finalise, and reporting lag differs by state. Treat month-to-month movement as direction, not a settled total.
Two denominators appear on this page. City-level presence uses all 4,111 treatment cities: 2,810 of them contain no listed detox provider within the city itself. Distance measures use the 4,041 of those cities with sufficient geographic data to be measured; the remaining 70 had no usable facility coordinates and are excluded from every distance figure, including the 7.9-mile median and the >25 and >50 mile counts.
Published September 2, 2026. SAMHSA facility export retrieved August 16, 2026. Analysis output generated 2026-09-02. Overdose figures are a live CDC provisional series and carry their own 12-month period, shown above. The SAMHSA facility file and the CDC series have different update cycles and are not a matched snapshot.
Both datasets below are the direct output of the analysis. Every figure on this page can be recomputed from them; the city file carries distances to three decimals so threshold counts reproduce exactly.
The providers-per-100-deaths ratio is computed only across the states and territories that appear in both datasets: 52 jurisdictions, 2,261 listed detox providers against 67,519 provisional overdose deaths, or 3.3 per 100. That denominator is the sum of state-level provisional counts and differs from the CDC's national figure of 66,937, which is modelled separately and adjusted for reporting lag. CDC publishes New York State excluding New York City, with New York City as its own row; because facility counts here are state-wide, the two rows are added together before the New York ratio is computed.
The SAMHSA service codes used here identify that a facility reports a detoxification service, not the level at which it is delivered. Reported services may include ambulatory as well as inpatient or medically managed withdrawal, so this page uses “detoxification services” rather than “medical detox” throughout.
Everything on this page is reproducible from the two files linked below.
Both datasets are released under a Creative Commons Attribution 4.0 licence. Journalists, researchers and public health agencies are free to republish, chart and build on them. Attribution to Treatment Locators with a link to this page is all we ask.
State-level dataset (CSV)
52 rows — facility counts, detox share, median distance and remote city counts.
City-level dataset (CSV)
4,111 rows — every treatment city with its straight-line distance to the nearest listed detox provider (blank where coordinates were unavailable).
Treatment Locators. “The U.S. Detox Access Gap.” September 2, 2026. Analysis of substance use treatment facility data published by SAMHSA in its national treatment locator, retrieved August 16, 2026. Medically reviewed by Cole Timonere, PhD, JD, LMHC, LPCC. https://treatmentlocators.com/research/detox-access-gap
Released under CC BY 4.0. Attribute Treatment Locators and link to this page.
This page is an independent analysis of publicly available treatment-facility data. The underlying facility records and a plain-language explanation of what detoxification services involve are published separately.
