Addiction treatment deserts in the U.S.
Here a county counts as a detox desert when its population center is more than 30 straight-line miles from the closest program that offers medical detox. Same cutoff for methadone. We ran it for all 3,144 counties.
23.5Mpeople in counties 30+ miles from detox
23.0Mpeople in counties 30+ miles from methadone
777counties with no program inside
See all states ranked Download the data
Farthest from medical detox (counties over 10,000 people)
| # | County | Population | Distance | Nearest detox |
|---|---|---|---|---|
| 1 | North Slope Borough, AK | 10,663 | 636 mi | Mat Su VA Community Based Outpatient, Wasilla |
| 2 | Ketchikan Gateway Borough, AK | 13,677 | 594 mi | Lummi Counseling Services & Suboxone Clinic, Bellingham |
| 3 | Juneau City and Borough, AK | 31,572 | 421 mi | Sound Alternatives, Cordova |
| 4 | Bethel Census Area, AK | 18,237 | 414 mi | Wisdom Traditions Counseling Services, Anchorage |
| 5 | Kodiak Island Borough, AK | 12,654 | 252 mi | Wisdom Traditions Counseling Services, Anchorage |
| 6 | Fairbanks North Star Borough, AK | 94,951 | 230 mi | Mat Su VA Community Based Outpatient, Wasilla |
| 7 | Elko County, NV | 54,363 | 147 mi | Renaissance Ranch, Heyburn |
| 8 | Union County, OR | 26,058 | 145 mi | Northpoint Recovery, Meridian |
| 9 | Hughes County, SD | 17,526 | 140 mi | iRecover US, Howard |
| 10 | Aroostook County, ME | 66,776 | 134 mi | Nightingale Hospital, Bangor |
| 11 | Custer County, MT | 11,964 | 126 mi | Volunteers of America, Sheridan |
| 12 | Humboldt County, NV | 17,116 | 120 mi | New Frontier, Fallon |
| 13 | Box Butte County, NE | 10,703 | 119 mi | Cheyenne VA Healthcare System, Cheyenne |
| 14 | Idaho County, ID | 17,912 | 119 mi | Providence St Patrick Hospital, Missoula |
| 15 | Webb County, TX | 272,823 | 117 mi | Tranquilo Wellness, Uvalde |
| 16 | Yuma County, CO | 10,048 | 114 mi | The Ranch at, Watkins |
| 17 | Brown County, SD | 37,495 | 111 mi | iRecover US, Howard |
| 18 | Sweetwater County, WY | 41,273 | 110 mi | Volunteers of America, Riverton |
| 19 | Moffat County, CO | 13,142 | 107 mi | Harmony Recovery, Estes Park |
| 20 | Walla Walla County, WA | 62,068 | 107 mi | Comprehensive Healthcare, Yakima |
| 21 | Baker County, OR | 16,750 | 106 mi | Northpoint Recovery, Meridian |
| 22 | Washington County, UT | 207,943 | 105 mi | VA Southern Nevada Healthcare System, North Las Vegas |
| 23 | Glacier County, MT | 13,503 | 103 mi | Rmtc Llc, Great Falls |
| 24 | Kauai County, HI | 73,840 | 97 mi | Zenith Behavioral Health, Wahiawa |
| 25 | Park County, MT | 18,074 | 97 mi | Montana Chemical Dependency Ctr, Butte |
Farthest from a methadone clinic
| # | County | Population | Distance | Nearest OTP |
|---|---|---|---|---|
| 1 | Kauai County, HI | 73,840 | 2,428 mi | Aegis Treatment Centers, LLC, Eureka |
| 2 | Honolulu County, HI | 998,747 | 2,384 mi | Aegis Treatment Centers, LLC, Eureka |
| 3 | Maui County, HI | 163,688 | 2,338 mi | New Life Health Authority, Ukiah |
| 4 | Hawaii County, HI | 209,790 | 2,336 mi | Veterans Affairs Medical Center, San Francisco |
| 5 | North Slope Borough, AK | 10,663 | 437 mi | Interior AIDS Association, Fairbanks |
| 6 | Bethel Census Area, AK | 18,237 | 414 mi | WCHS, Inc., Anchorage |
| 7 | Kodiak Island Borough, AK | 12,654 | 253 mi | WCHS, Inc., Anchorage |
| 8 | Lincoln County, NE | 33,319 | 212 mi | Colorado Treatment Services LLC, Greeley |
| 9 | Hill County, MT | 16,065 | 198 mi | Community Medical Services- Billings, Billings |
| 10 | Campbell County, WY | 47,946 | 182 mi | Community Medical Services- Billings, Billings |
| 11 | Roosevelt County, MT | 10,197 | 181 mi | Community Medical Services, Minot |
| 12 | Red Willow County, NE | 10,409 | 173 mi | New Chance Inc, Dodge City |
| 13 | Lawrence County, SD | 28,809 | 172 mi | Capital Area Counseling Services, Pierre |
| 14 | Butte County, SD | 10,891 | 171 mi | Capital Area Counseling Services, Pierre |
| 15 | Natrona County, WY | 80,410 | 171 mi | Vcphcs X, Llc, Fort Collins |
| 16 | Dawson County, NE | 24,554 | 167 mi | Lincoln Treatment Center, LLC, Lincoln |
| 17 | Custer County, NE | 10,487 | 162 mi | Lincoln Treatment Center, LLC, Lincoln |
| 18 | Houghton County, MI | 38,041 | 159 mi | Wausau Comprehensive Treatment Center, Wausau |
| 19 | Converse County, WY | 13,766 | 156 mi | Vcphcs X, Llc, Fort Collins |
| 20 | Box Butte County, NE | 10,703 | 152 mi | Colorado Treatment Services LLC, Greeley |
| 21 | Elko County, NV | 54,363 | 149 mi | North Canyon Medical Center, Gooding |
| 22 | Humboldt County, NV | 17,116 | 147 mi | Life Change Center, Sparks |
| 23 | Meade County, SD | 30,918 | 147 mi | Capital Area Counseling Services, Pierre |
| 24 | Pennington County, SD | 115,979 | 145 mi | Capital Area Counseling Services, Pierre |
| 25 | Custer County, MT | 11,964 | 139 mi | Community Medical Services- Billings, Billings |
Largest counties with no treatment program inside
| County | Population | Nearest program |
|---|---|---|
| Platte County, MO | 113,207 | 6.1 mi (Kansas City) |
| Steuben County, NY | 92,015 | 25 mi (Watkins Glen) |
| Elmore County, AL | 91,042 | 13 mi (Montgomery) |
| Walton County, FL | 89,666 | 24 mi (Panama City Beach) |
| Rockingham County, VA | 87,674 | 1.7 mi (Harrisonburg) |
| Coryell County, TX | 86,370 | 13 mi (Killeen) |
| Clinton County, MI | 80,050 | 9.2 mi (Lansing) |
| Harrison County, TX | 71,370 | 17 mi (Longview) |
| Tehama County, CA | 64,451 | 26 mi (Orland) |
| Autauga County, AL | 61,464 | 13 mi (Montgomery) |
| St. Joseph County, MI | 61,171 | 16 mi (Lagrange) |
| Otsego County, NY | 60,524 | 24 mi (Norwich) |
| Pearl River County, MS | 59,030 | 15 mi (Bogalusa) |
| Chambers County, TX | 56,179 | 13 mi (Baytown) |
| Pulaski County, MO | 53,964 | 22 mi (Rolla) |
| Calumet County, WI | 53,602 | 9.7 mi (Menasha) |
| Kendall County, TX | 51,828 | 13 mi (San Antonio) |
| Bryan County, GA | 51,105 | 9.6 mi (Bloomingdale) |
| St. Charles Parish, LA | 50,400 | 9.1 mi (Kenner) |
| McClain County, OK | 48,434 | 7.0 mi (Norman) |
| Hancock County, MS | 46,492 | 19 mi (Gulfport) |
| Jackson County, NC | 45,281 | 12 mi (Cherokee) |
| Oconee County, GA | 44,751 | 4.5 mi (Athens) |
| Muscatine County, IA | 42,132 | 21 mi (Wapello) |
| Louisa County, VA | 42,109 | 21 mi (Goochland) |
Method
Program locations come from SAMHSA's FindTreatment.gov locator (substance use and co-occurring programs). County boundaries and 2020 population centers come from the U.S. Census Bureau; population figures are 2024 Census estimates. Distances are straight-line ("as the crow flies") from each county's population center; real driving distances are longer. Data may be cited with a link to this page.