Residential Drug Rehab in Texas

If someone you love is losing ground to opioids, meth, cocaine, benzodiazepines or another drug, residential rehab gives them something outpatient care can't: a safe place to live while they start over, with structured treatment every day and people awake and on site around the clock. Texas has residential drug rehab centers in every major metro and in many smaller cities, and most people with commercial insurance can find an in-network program without leaving the state.

This page explains what residential drug rehab looks like under Texas rules, how to check that a program is licensed, how Texas insurance plans handle residential care, and how to choose a program near home. Below you'll find programs by region, county and city, with the closest options listed first wherever you are in Texas.

What residential drug rehab means in Texas

Texas regulates addiction treatment through the Health and Human Services Commission (HHSC). State rules describe residential treatment as round-the-clock, multidisciplinary clinical care in a residential setting with a structured therapeutic environment. In plain terms: you live at the program, you follow a daily schedule of counseling, education and recovery activities, and staff are present day and night.

Texas rules set two residential intensities. Intensive residential programs must average at least 30 hours of services per client each week, including at least 10 hours of chemical dependency counseling (one hour of it individual), 10 hours of education and life skills, and 10 hours of planned activities, with five of those activity hours on evenings and weekends. Supportive residential is a lighter level, with at least 6 hours of treatment services a week, often used as a step-down. Every residential program must have a counselor on duty at least eight hours a day, six days a week, and direct care staff awake and on site at all hours.

Staffing ratios are set too: adult intensive residential programs keep at least one direct care staff member for every 16 clients while clients are awake and one for every 32 during sleeping hours, and a counselor can carry no more than 10 clients. Group counseling is capped at 16 people. Those numbers are worth asking about on a tour; a program that meets them comfortably usually isn't stretched thin.

Who residential drug rehab is for

Residential care fits people whose drug use has outrun what weekly outpatient sessions can handle. Common signs include repeated relapses after outpatient treatment, overdoses or near-misses, use that continues despite losing a job, custody or health, a home environment where drugs are easy to get, or withdrawal that needs medical supervision first. National Institute on Drug Abuse research is clear that no single treatment fits everyone and that the setting should match the person's needs. For many Texans, a few weeks away from the people, places and routines tied to using is what makes change possible.

If the person is still using heavily, residential rehab usually starts with medical detox. Detox manages withdrawal safely; it isn't treatment on its own, and NIDA stresses that it does little to change long-term drug use unless it's followed by ongoing care.

Check the license before you commit

Under Texas Health and Safety Code Sec. 464.002, a person or program can't offer chemical dependency treatment without a state license unless it qualifies for an exemption. Licenses last two years. Programs that use only nonmedical methods such as prayer or spiritual counseling don't need a treatment license but must register with HHSC as faith-based programs, which means they aren't licensed to provide clinical treatment. You can look up any facility through the HHSC chemical dependency treatment facility page, which links to HHSC's online licensing system and its downloadable directory of licensed facilities. If you have concerns about a program's care, HHSC Complaint and Incident Intake takes complaints online around the clock.

Two more Texas protections are worth knowing. Licensed programs can't deny admission to, or discharge, someone just because they take prescribed medication. And programs can't turn someone away because of a mental health history or current psychiatric medications, which matters for anyone who also needs dual diagnosis treatment.

Residential Drug Rehab 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; 58 report accepting private health insurance in the SAMHSA directory. Always confirm services directly.

Paying for residential drug rehab in Texas

Most Texans in rehab pay through commercial health insurance. Texas Insurance Code Chapter 1368 requires group health plans to cover necessary chemical dependency treatment, and Sec. 1368.005 says that coverage can't be less favorable than coverage for physical illness. Texas's parity law (House Bill 10, effective for plans issued or renewed from January 1, 2018) and the federal Mental Health Parity and Addiction Equity Act add that copays, deductibles, visit limits and prior authorization rules for substance use care can't be stricter than those for comparable medical and surgical care.

In practice, residential stays usually need prior authorization, and the plan reviews medical necessity as treatment goes on. Before you choose a program, find out whether it's in network for your plan, whether your plan requires precertification, and what your deductible and out-of-pocket maximum are. A program's admissions team can usually run that check for you with the member ID card.

Major Texas carriers and residential drug rehab

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

If a plan denies residential care, you can appeal. Look at your ID card: if it shows "TDI" or "DOI," your plan is fully insured and regulated by the Texas Department of Insurance, and TDI's consumer help line can walk you through internal appeals and a free independent review whose decision the plan must follow. Many large employer plans are self-funded and regulated federally instead, under ERISA. Our guide to insurance coverage for rehab in Texas covers each step.

Staying close to home in Texas

Unlike states that draw patients from across the country, most people in Texas rehab are Texans, and there are good reasons to stay in state. In-network benefits are easiest to use with a Texas program on your own plan's network. Family can visit and take part in family sessions. And aftercare is simpler to set up when the residential team knows the outpatient programs and recovery community you'll go home to. Texas is big, though: a program two hours away is still close by Texas standards, and some people choose a program in another region precisely to get distance from the places they used.

Residential Drug Rehab by region

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

How to choose a residential drug rehab

• License and level of care. Confirm the license with HHSC and ask whether the program is intensive or supportive residential, and whether it offers detox on site.
• Your substance and your history. Ask how the program treats your specific drug, including medications for opioid use disorder if opioids are involved, and how it handles relapse history.
• Mental health care. If depression, anxiety, trauma or another condition is part of the picture, ask who provides psychiatric care and how often.
• Insurance. Get the network status and precertification answer in writing before admission.
• Length of stay. NIDA's research says most people need at least three months in treatment overall; ask how the program plans the step-down after residential.
• Family involvement. Ask about family sessions, visiting and what support exists for you.
• Discharge planning. The best programs start planning outpatient care, recovery housing and support meetings in the first week.

What a typical stay looks like

The first days focus on assessment, stabilization and settling in. Most days then follow a set rhythm: morning group, individual counseling, education on addiction and relapse prevention, life skills, exercise or recreation, and evening activities or support meetings. Evenings and weekends aren't empty time; Texas intensive residential rules require part of the week's planned activities to fall then. Toward the end of the stay, the focus shifts to the plan for home: outpatient treatment, sober living if needed, medication management and support for the family.

Find residential drug rehab near you

Residential Drug Rehab in Texas's largest cities

• Dallas (121 within 25 mi)
• Houston (118 within 25 mi)
• San Antonio (40 within 25 mi)
• Austin (67 within 25 mi)
• Fort Worth (69 within 25 mi)
• El Paso (18 within 25 mi)
• McAllen (18 within 25 mi)
• Denton (47 within 25 mi)
• Arlington (102 within 25 mi)
• Corpus Christi (13 within 25 mi)
• Plano (115 within 25 mi)
• Lubbock (12 within 25 mi)
• Laredo (5 within 25 mi)
• McKinney (71 within 25 mi)
• Killeen (12 within 25 mi)
• Garland (114 within 25 mi)
• Irving (148 within 25 mi)
• Brownsville (11 within 25 mi)
• College Station (5 within 25 mi)
• Amarillo (9 within 25 mi)
• Frisco (98 within 25 mi)
• Grand Prairie (119 within 25 mi)
• Waco (10 within 25 mi)
• Odessa (12 within 25 mi)
• Midland (12 within 25 mi)
• Port Arthur (15 within 25 mi)
• Pasadena (108 within 25 mi)
• Beaumont (15 within 25 mi)
• Tyler (14 within 25 mi)
• Mesquite (84 within 25 mi)

Residential Drug Rehab 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.

Residential Drug Rehab by county

• Harris County (103)
• Dallas County (63)
• Tarrant County (52)
• Travis County (42)
• Bexar County (39)
• Collin County (37)
• Denton County (24)
• Fort Bend County (22)
• Brazoria County (20)
• Hidalgo County (18)
• El Paso County (18)
• Williamson County (18)
• Galveston County (15)
• Jefferson County (14)
• Hays County (13)
• Montgomery County (12)
• Bell County (12)
• Smith County (12)
• Lubbock County (12)
• Cameron County (11)
• Nueces County (11)
• McLennan County (10)
• Wichita County (8)
• Grayson County (8)
• Ector County (8)
• Bastrop County (8)
• Kaufman County (7)
• Potter County (6)
• Johnson County (6)
• Taylor County (6)
• Ellis County (6)
• Parker County (5)
• Kerr County (5)
• Comal County (5)
• Tom Green County (5)
• Brazos County (5)
• Webb County (5)
• Gregg County (4)
• Angelina County (4)
• Midland County (4)
• Liberty County (3)
• Bowie County (3)
• Hale County (3)
• Henderson County (3)
• Rockwall County (3)
• Waller County (3)
• San Patricio County (3)
• Gonzales County (3)
• Randall County (3)
• Harrison County (3)
• Starr County (2)
• Walker County (2)
• Chambers County (2)
• Hamilton County (2)
• Hunt County (2)
• Hutchinson County (2)
• Austin County (2)
• Hill County (2)
• Palo Pinto County (2)
• Bandera County (2)
• Wood County (2)
• Nacogdoches County (2)
• Wilbarger County (2)
• Val Verde County (2)
• Lamar County (2)
• Victoria County (2)
• Zapata County (2)
• Brown County (2)
• Cherokee County (2)
• Howard County (2)
• Matagorda County (2)
• Anderson County (2)
• Gillespie County (2)
• Washington County (2)
• Ochiltree County (2)
• Wilson County (1)
• Brewster County (1)
• Navarro County (1)
• Bee County (1)
• Deaf Smith County (1)
• Rusk County (1)
• Bailey County (1)
• Van Zandt County (1)
• Hardin County (1)
• Upshur County (1)
• Pecos County (1)
• Gray County (1)
• Caldwell County (1)
• Falls County (1)
• Madison County (1)
• Willacy County (1)
• Wise County (1)
• Tyler County (1)
• Moore County (1)
• Cooke County (1)
• Limestone County (1)
• Kendall County (1)
• Kleberg County (1)
• Erath County (1)
• Hardeman County (1)
• Orange County (1)
• Maverick County (1)
• Wharton County (1)
• Burnet County (1)
• Uvalde County (1)
• Panola County (1)
• Fayette County (1)
• Polk 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

• Who Pays for Court-Ordered Rehab in Texas?
• What Is Residential Treatment for Addiction in Texas?
• The Texas Good Samaritan Overdose Law and Naloxone: What Families Should Know
• Faith-Based and Christian Rehab in Texas: Licensed vs Registered Programs
• Pet-Friendly Rehab in Texas: What It Means and What to Ask
• Does Aetna Cover Rehab in Texas?

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