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People who decide they want help usually hit the same wall right away. They do not know who to call first. They search, find fifty treatment centers, and close the browser. Sometimes a person only needs a phone number. Sometimes they need a number, a cost answer, and a short list of questions before they will pick up the phone at all.
I facilitate groups, and I hear some version of “I didn’t know where to start” a lot. This guide is the short version of where to start. It is not medical advice, and it does not replace a doctor or a treatment program. It points to the official services that do that work.
Direct Answer
- If someone is in immediate danger, call 911.
- If you or someone else is in a mental health or substance use crisis, call or text 988. The 988 Suicide & Crisis Lifeline is free and confidential, and you do not have to be suicidal to call. Substance use is one of the reasons it lists.[1]
- If you want treatment and do not know where to begin, call SAMHSA’s National Helpline at 1-800-662-HELP (4357). It is free, confidential, open 24 hours a day, 365 days a year, and gives referrals to local treatment facilities, support groups, and community organizations.[2]
- If you would rather not talk yet, text your five-digit ZIP code to 435748 (HELP4U) for local referrals, or search the federal treatment locator at FindTreatment.gov.[2][3]
988 and the National Helpline do different jobs
People mix these two up all the time, and that is understandable. Both are free. Both are confidential. Both are run with federal support. They are still built for different moments.
988 is for crisis. A trained counselor answers by call, text, or chat. The Lifeline says people can call for substance use, depression, relationship problems, money worries, loneliness, and more.[1] If the problem is happening tonight and you need to talk to someone right now, 988 is the call.
The National Helpline is for referral. Information specialists answer, and they connect callers to state services, intake centers, and local programs. The Helpline says plainly that it does not provide counseling.[2] If the question is “where can I get treatment near me,” the Helpline is the call.
You do not have to get this exactly right. If you call one and need the other, tell them what is going on.
What it costs, and what to do if you have no insurance
Cost is the reason a lot of people never make the second call. The referral itself is free.[2]
If you have no insurance or are underinsured, SAMHSA says the Helpline will refer you to your state office that runs state-funded treatment programs. It can also often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid.[2]
If you do have insurance, SAMHSA encourages you to contact your insurer for a list of participating providers and facilities.[2] The member services number is usually on the back of your insurance card. Ask which programs are in network before you agree to an intake, so a bill does not become the reason you stop going.
What to ask a treatment program
Once you have a few names, the next question is which one. SAMHSA publishes a checklist for that, and it says you can ask a trusted person to help you compare.[4] In plain terms, these are the questions it points to:
- Is the program licensed and accredited? SAMHSA says all programs and their health care professionals should be.[4]
- Does it use evidence-based practices? SAMHSA lists examples like motivational interviewing, cognitive behavioral therapy, education about your condition, and social skills training.[4]
- Can my family be part of treatment if I want them to be?[4]
- Will you help with other parts of my life? SAMHSA notes many programs help people get other medical care and benefits such as housing, food assistance, job placement, and long-term recovery support.[4]
- Do you offer medication for alcohol or opioid use? SAMHSA says a program should only provide FDA-approved medication for alcohol, tobacco, or opioid use, and that there are currently no FDA-approved medications to prevent a return to use for substances such as methamphetamine and cocaine.[4]
If a program cannot answer those questions clearly, that tells you something. Write the answers down so you can compare them later. SAMHSA has a worksheet for this on the same page.[4]
A simple order of steps
When I talk with someone who is ready, this is the order I would walk through with them.
- Safety first. If anyone is in danger, call 911. If it is a crisis, call or text 988.[1]
- Get names. Call the National Helpline, text your ZIP code to 435748, or search FindTreatment.gov.[2][3]
- Sort out cost. Call your insurer, or ask the Helpline about state-funded and sliding-fee programs.[2]
- Compare two or three programs with the questions above.[4]
- Make the appointment while you still want it. If there is a wait, ask what support is available in the meantime, such as a support group.[2]
- Tell one person you trust what you are doing.
Step six is not in any federal checklist. It comes from the groups I facilitate, and it is the step I would keep if I could only keep one.
For families
If you are calling for someone you love, all of these numbers work for you too. The National Helpline serves individuals and family members.[2] The 988 Lifeline also offers guidance for helping someone else.[1] If you are trying to figure out what to say after a return to use, I wrote about that in what to say when a loved one relapses.
What this page is not
This is not a directory, and it is not a review of any treatment center. It does not cover every option, such as private therapists, peer recovery coaches, or mutual-help groups, in detail. My longer recovery resources page covers more of the types of support, and quitting without treatment access covers what to do when a program is out of reach.
The goal here is smaller. If you are ready to ask for help, you should not lose that moment because you did not know which number to dial.
Programs that want a facilitator-led curriculum beside their existing care can look at the curriculum. My own story with addiction and recovery is in A Vision of Hope.
Frequently Asked Questions
What number do I call for addiction help?
For a treatment referral, call SAMHSA’s National Helpline at 1-800-662-4357. It is free, confidential, and open 24/7. For a crisis, call or text 988. If someone is in immediate danger, call 911.[1][2]
Can I call 988 for drug or alcohol problems?
Yes. The 988 Lifeline says you do not have to be suicidal to call, and it lists substance use as one of the reasons people reach out.[1]
Is the SAMHSA National Helpline free?
Yes. The referral service is free and confidential, and SAMHSA says it will not ask for personal information. It may ask for a ZIP code to find local resources.[2]
Does the National Helpline provide counseling?
No. Trained information specialists answer and connect callers with state services, intake centers, and local programs. For crisis counseling, use 988.[1][2]
How do I find addiction treatment with no insurance?
Call the National Helpline. SAMHSA says it refers people without insurance to their state office for state-funded treatment, and often to facilities that use a sliding fee scale or accept Medicare or Medicaid.[2]
How do I know if a treatment program is good?
SAMHSA’s checklist says to look for licensing and accreditation, evidence-based practices, family involvement, help with other parts of life, and FDA-approved medication for alcohol or opioid use.[4]
References
- 988 Suicide & Crisis Lifeline. Get Help. https://988lifeline.org/get-help/
- Substance Abuse and Mental Health Services Administration. SAMHSA’s National Helpline. https://www.samhsa.gov/find-help/helplines/national-helpline
- Substance Abuse and Mental Health Services Administration. FindTreatment.gov. https://findtreatment.gov/
- Substance Abuse and Mental Health Services Administration. Quality Treatment for Mental Health, Drugs and Alcohol. Last updated April 24, 2023. https://www.samhsa.gov/find-support/learn-about-treatment/finding-quality-treatment