Medical Detox in Texas

Detox is the first step for many people entering treatment: getting the alcohol or drugs out of the body safely, with medical staff managing withdrawal symptoms around the clock. For alcohol, benzodiazepines and heavy opioid use, withdrawal can range from miserable to dangerous, and trying it alone at home is one of the most common reasons people go back to using within days.

This page explains what Texas requires of licensed detox programs, which substances most need medical detox, how long it usually takes, how insurance covers it, and why detox should always lead somewhere next. Texas detox centers are listed by region, county and city below.

What Texas requires of a detox program

Texas licenses detox programs as part of its chemical dependency treatment facility rules (26 Texas Administrative Code Sec. 564.902). A licensed detox program must:

• have a licensed physician as medical director and follow nationally recognized withdrawal protocols;
• complete a face-to-face history and physical with signed admission orders within 24 hours of admission;
• keep a physician, or a physician's designee, on call around the clock;
• have a licensed nurse (LVN or RN) on duty at least eight hours every day;
• in residential detox, check withdrawal symptoms, vital signs and mental status every four hours for the first 72 hours, then as the physician orders;
• guarantee continuous access to emergency medical care, with direct care staff with residential detox clients at all times.

Texas also allows ambulatory (outpatient) detox, but only together with outpatient treatment, never as a stand-alone service. Verify any program's license through the HHSC chemical dependency treatment facility page.

Which withdrawals need medical detox

Alcohol

Alcohol withdrawal can be life-threatening. NIAAA notes it drives roughly 260,000 emergency visits and about 850 deaths a year in the U.S., with seizures and delirium tremens among the dangers. Inpatient detox is recommended for people at risk of severe withdrawal, and benzodiazepines are the first-line treatment. See inpatient alcohol rehab.

Benzodiazepines and other sedatives

Stopping benzodiazepines such as alprazolam, clonazepam or diazepam suddenly after regular use can also cause seizures. Withdrawal is usually managed with a gradual, physician-supervised taper, sometimes over weeks.

Opioids, including fentanyl

Opioid withdrawal is rarely life-threatening on its own but is intensely uncomfortable, and the risk of fatal overdose rises sharply if someone relapses after their tolerance drops. Detox is a good time to start buprenorphine or another medication for opioid use disorder, which can continue into treatment. Ask every program about this.

Stimulants

Withdrawal from methamphetamine or cocaine usually isn't medically dangerous, but the crash can bring severe depression, exhaustion and suicidal thoughts. A supervised setting helps, especially with co-occurring mental health symptoms.

Detox is a first step, not treatment

NIDA's research principles stress that medically assisted detox is only the first stage of treatment and does little by itself to change long-term drug use, and NIAAA calls alcohol detox a critical first step that has to be followed by ongoing care. The best detox programs plan the next step from day one: a transfer to residential treatment, a direct handoff to intensive outpatient care, or both.

Medical Detox in Texas at a glance

Counts come from this directory, which combines the SAMHSA National Directory of Substance Use Treatment Facilities with public business listings. "Confirmed" programs are those whose SAMHSA service codes or listings show residential, inpatient or detox care; 45 report accepting private health insurance in the SAMHSA directory. Always confirm services directly.

Insurance for detox in Texas

Medically necessary detox is generally covered by commercial health plans, and inpatient detox usually needs prior authorization. Texas Insurance Code Chapter 1368 requires group plans to cover chemical dependency treatment on terms no less favorable than physical illness. In an emergency, go to the nearest emergency department; emergency care doesn't need prior approval.

Major Texas carriers and medical detox

Plan rules vary, and self-funded employer plans can differ. Always confirm benefits with the member services number on your ID card.

If you're uninsured, your region's Texas OSAR center can screen you and refer you to state-funded detox. Each county page lists its OSAR.

How long detox takes

Most medically supervised detox stays last several days to a week or so, depending on the substance, how long and how heavily it was used, and the person's health. Benzodiazepine tapers can take longer and often continue after the inpatient portion.

Medical Detox by region

Texas's Health and Human Services Commission organizes services into 11 health service regions. Here's where medical detox programs on our list are located.

Overdose safety during and after detox

For people using opioids, the days and weeks after detox carry special risk: tolerance drops quickly, so a dose that was once routine can be fatal. Keep naloxone on hand. The FDA approved over-the-counter naloxone nasal spray in 2023, and Texas law lets prescribers prescribe it to family and friends of someone at risk. Texas's 2021 overdose law gives a defense to small-amount possession charges for the first person who calls 911 for an overdose and stays to cooperate, and for the person who overdosed, with some limits. Starting buprenorphine or another medication for opioid use disorder during detox also lowers overdose risk.

Choosing a detox program

• Is it licensed for residential detox, and is a physician on call at night?
• Which substances does it manage, and does it handle alcohol and benzodiazepine withdrawal?
• Does it start medications for opioid use disorder?
• Can it transfer you straight into residential or outpatient treatment?
• Is it in network with your plan, and has precertification been requested?

Find a detox center near you

Medical Detox in Texas's largest cities

• Dallas (19 within 25 mi)
• Houston (9 within 25 mi)
• San Antonio (4 within 25 mi)
• Austin (7 within 25 mi)
• Fort Worth (13 within 25 mi)
• El Paso (1 within 25 mi)
• McAllen (0 within 25 mi)
• Denton (11 within 25 mi)
• Arlington (16 within 25 mi)
• Corpus Christi (0 within 25 mi)
• Plano (18 within 25 mi)
• Lubbock (0 within 25 mi)
• Laredo (0 within 25 mi)
• McKinney (9 within 25 mi)
• Killeen (1 within 25 mi)
• Garland (16 within 25 mi)
• Irving (24 within 25 mi)
• Brownsville (2 within 25 mi)
• College Station (0 within 25 mi)
• Amarillo (1 within 25 mi)
• Frisco (14 within 25 mi)
• Grand Prairie (20 within 25 mi)
• Waco (0 within 25 mi)
• Odessa (2 within 25 mi)
• Midland (2 within 25 mi)
• Port Arthur (0 within 25 mi)
• Pasadena (11 within 25 mi)
• Beaumont (0 within 25 mi)
• Tyler (1 within 25 mi)
• Mesquite (10 within 25 mi)

Medical Detox programs across Texas

One program from each of several Texas counties, confirmed programs first. Use the county and city links for the closest options to you.

Medical Detox by county

• Dallas County (10)
• Harris County (9)
• Tarrant County (9)
• Travis County (6)
• Collin County (6)
• Denton County (4)
• Bexar County (4)
• Ellis County (4)
• Cameron County (2)
• Brazoria County (2)
• Fort Bend County (2)
• Montgomery County (2)
• Kerr County (2)
• Williamson County (2)
• Galveston County (2)
• Rusk County (1)
• Potter County (1)
• Van Zandt County (1)
• Johnson County (1)
• El Paso County (1)
• Austin County (1)
• Parker County (1)
• Hays County (1)
• Comal County (1)
• Midland County (1)
• Ector County (1)
• Taylor County (1)
• Tom Green County (1)
• Bell County (1)
• Smith County (1)
• Gonzales County (1)
• Maverick County (1)

Don't see your county? Every county has a page with the nearest programs: browse all 254 Texas counties.

Other types of care

Related guides

• What Is Court-Ordered Rehab in Texas? Chapter 462 Explained
• How to File for Court-Ordered Rehab in Texas: Step by Step
• Chapter 462 vs Mental Health Commitment in Texas
• Emergency Detention and Protective Custody Under Texas Chapter 462
• Who Pays for Court-Ordered Rehab in Texas?
• Inpatient vs Residential Rehab: What's the Difference?

This page is general information, not medical or legal advice. Confirm services, licensing and insurance directly with any program.