A free guide from Cima Find Care

Alcohol detox in Texas: do you need it, and where to go

If you drink heavily and often, don't stop suddenly on your own: alcohol withdrawal can turn dangerous fast. Medical detox (also called withdrawal management) keeps you safe while your body adjusts. Many people can detox as outpatients, with daily visits; others need 24-hour care. Texas Medicaid, private insurance, Medicare and state-funded programs all pay for it. Of the Texas programs on Cima Find Care, 184 offer detox, and 119 of them accept Medicaid.

Updated October 27, 2026. General information, not medical, legal or insurance advice.

If you need help now: call 911 in an emergency, including seizures, severe confusion or hallucinations during withdrawal. In a mental health or substance use crisis, call or text 988, any time. SAMHSA's National Helpline, 1-800-662-4357, is free, confidential and open 24/7 for treatment referrals.

The short version

Don't quit cold turkey alone if you drink heavily every day or have had withdrawal before. Call a doctor or a detox program first.
Get assessed. A clinician checks your drinking, health and past withdrawal and recommends outpatient or inpatient detox.
Check who pays. Call the number on your insurance card. With no insurance, call 2-1-1 and ask for the OSAR program (Outreach, Screening, Assessment and Referral).
Plan the next step before detox ends. Detox treats withdrawal, not the drinking itself. Treatment afterward is what helps you stay well.

Signs of alcohol withdrawal

MedlinePlus, from the National Library of Medicine, lists these common symptoms:

Shakiness, jumpiness, anxiety or irritability
Sweating or clammy skin
Nausea or vomiting, loss of appetite
Trouble sleeping, nightmares
Headache and a fast heart rate

When	What can happen
Within 8 hours of the last drink	Symptoms usually start, though they can start days later.
12 to 48 hours	Withdrawal seizures are most likely in this window.
24 to 72 hours	Symptoms usually peak. They can go on for weeks.
48 to 96 hours	Delirium tremens (DTs), the most severe form, most often starts now, but it can start 7 to 10 days after the last drink.

When it's an emergency

MedlinePlus calls alcohol withdrawal a serious condition that may quickly become life-threatening. Call 911 or go to the emergency room for:

A seizure
Severe confusion, or seeing or hearing things that aren't there
A fever
An irregular heartbeat

If you think you're in withdrawal, especially after drinking often and stopping recently, call your doctor right away or go to the ER.

Do I need detox?

NIAAA says up to half of people with alcohol use disorder have some withdrawal symptoms when they stop, and a smaller group need medical care and monitoring, or detox, to get through them safely. A clinician decides with you. Medical detox is especially important when you have any of these risk factors for severe or complicated withdrawal, from the American Society of Addiction Medicine (ASAM) guideline:

A past withdrawal seizure or delirium tremens
Many past withdrawals
Other serious medical or surgical illness, especially a head injury
Age over 65
Heavy drinking over a long time
A seizure during this withdrawal

Not sure? Call a detox program or your doctor and describe how much and how often you drink. It's the safest first step.

Outpatient vs inpatient detox

ASAM's guideline says most people with alcohol withdrawal can be treated safely as outpatients, unless something calls for inpatient care. Texas Medicaid uses the same idea: outpatient detox for mild to moderate withdrawal that can be managed safely outside a residential program or hospital.

Type	What it looks like	Often a fit when
Outpatient (ambulatory) detox	You sleep at home and see the clinic every day, for checks and medication.	Withdrawal is expected to be mild to moderate, your health is otherwise stable, and someone sober can stay with you.
Residential detox	You stay at a licensed program with 24-hour monitoring.	Withdrawal could be severe, home isn't safe or supportive, or outpatient detox hasn't worked.
Hospital (inpatient) detox	A hospital bed with doctors and nurses around the clock.	You have serious medical problems, a seizure, DTs, or another condition that could make you unstable.

ASAM adds that people with little support at home, or an unsafe home, may do better in a more intensive setting. In ASAM's current levels of care, withdrawal care is built into Level 1.7 (medically managed outpatient), 2.7 (medically managed intensive outpatient), 3.5 and 3.7 (residential) and 4 (hospital). Our guide to IOP vs PHP vs weekly therapy explains these levels.

What happens in detox

An assessment: your drinking, other drugs, medications, health, past withdrawals and your home situation. With your permission, staff may ask family about past seizures or confusion.
Monitoring: staff check your symptoms, pulse and blood pressure regularly, using a standard scale.
Medication: ASAM's first choice for alcohol withdrawal is a benzodiazepine, because it reduces symptoms and the chance of seizures and delirium. You take it only under medical care.
Planning: a good program starts talking about your next step early, and may start a medication for alcohol use disorder.

How long it lasts depends on you. MedlinePlus says symptoms usually peak in 1 to 3 days but can last longer.

After detox: what comes next

Detox is only the first stage of treatment. The National Institute on Drug Abuse says it safely manages withdrawal but by itself does little to change long-term drinking or drug use, so people should go on to treatment. Options:

Residential treatment, living at a program for a period of time.
Partial hospitalization (PHP) or intensive outpatient (IOP), several hours a day while you live at home.
Outpatient counseling, one-on-one or in groups.
Medication: the FDA has approved naltrexone, acamprosate and disulfiram for alcohol use disorder. They aren't addictive.
Recovery support: mutual-support groups, a recovery coach or a sober living home (for example, recovery coaches and sober living homes in Houston).

Before you leave detox, book the next appointment, with a date and time, and ask whether it needs its own insurance approval.

Who pays for detox in Texas

Coverage	What to know
Private insurance	Every fully insured plan sold in Texas must include substance use benefits, and parity law keeps their rules in line with medical care. Self-funded employer plans don't have to cover it, but if they do, parity applies. Ask whether detox needs prior authorization and what you'll owe per day.
Texas Medicaid	Covers outpatient and residential withdrawal management at licensed programs. Both need prior authorization, which the program requests (it can ask within 3 business days after you're admitted). Outpatient detox can be approved for up to 21 days. Medicaid members pay no copays.
Medicare	Part A covers a stay in a general or psychiatric hospital; Part B covers outpatient substance use care. Ask any detox program that isn't a hospital whether it takes Medicare.
TRICARE and VA	TRICARE may cover detox, including emergency inpatient care. VA health care offers medically managed detox to enrolled veterans.
No insurance	Texas HHSC funds outpatient and residential withdrawal management for adults 18 and older who live in Texas, have a substance use disorder and meet income rules. Some people pay part of the cost. Call a program directly, your local OSAR, or 2-1-1.

More: does insurance cover rehab?, how to use your insurance in Texas and how to apply for Texas Medicaid. Under the federal parity law, a plan's approval rules for detox can't be stricter than for comparable medical care.

Alcohol detox near you in Texas

Counted from the programs on Cima Find Care, from SAMHSA's FindTreatment.gov and the programs' own records. Each number links to that city's list, with phone numbers, addresses and the insurance each program lists.

City	Detox	Residential
Austin	12 programs, 7 take Medicaid	16 programs, 10 take Medicaid
Dallas	10 programs, 6 take Medicaid	12 programs, 8 take Medicaid
El Paso	3 programs, 3 take Medicaid	8 programs, 8 take Medicaid
Fort Worth	3 programs, 1 takes Medicaid	3 programs, 2 take Medicaid
Houston	23 programs, 12 take Medicaid	26 programs, 16 take Medicaid
San Antonio	12 programs, 11 take Medicaid	13 programs, 11 take Medicaid

Other cities with detox lists: Amarillo, Arlington and Plano. Medicaid detox by city: Houston, San Antonio, Austin, Dallas and El Paso. Or search Texas providers by insurance, answer four quick questions to see where to start, or browse every Texas city.

Outside these cities, use SAMHSA's FindTreatment.gov or call its helpline, 1-800-662-4357, any time.

Questions to ask a detox program

Are you licensed? In Texas, substance use treatment programs need an HHSC chemical dependency treatment facility license, which you can look up on HHSC's site. Hospitals are licensed separately.
Is it outpatient or 24-hour care, and is a doctor or nurse available around the clock?
Do you take my insurance, and will you get the prior authorization?
What happens after detox? Do you help me get into treatment or start medication?
How soon can I start? Some programs admit the same day. If you might be in dangerous withdrawal, don't wait: go to an ER.

Helping someone else through this? Read how to help an alcoholic. For a teenager, see teen drug and alcohol treatment in Texas. More plain-language guides are on our guides page.

Questions people ask

Can you detox from alcohol at home?

Only with a clinician's plan. Outpatient detox means you sleep at home but see a clinic every day for checks and medication. Quitting cold turkey with no medical help is risky if you drink heavily, because seizures and DTs can come on quickly.

Does outpatient detox work?

For many people, yes. ASAM's guideline says most people with alcohol withdrawal can be treated safely as outpatients when nothing calls for inpatient care. People at risk of severe withdrawal, or with serious medical problems, usually need inpatient care.

How long does alcohol detox take?

It varies. Symptoms usually peak 24 to 72 hours after the last drink, but some last for weeks. Texas Medicaid can approve outpatient detox for up to 21 days.

Is detox free in Texas?

It can be. Medicaid members pay no copays for covered care. If you have no insurance and your income qualifies, Texas pays for detox at state-funded programs, though some people pay part. Private plans may charge a deductible, copay or coinsurance.

What's the difference between detox and rehab?

Detox treats withdrawal, usually over days. Rehab (residential, PHP, IOP or outpatient treatment) treats the alcohol use disorder itself, over weeks or months. Most people need both.

Can I go to the ER for alcohol withdrawal?

Yes. Go, or call 911, for seizures, fever, severe confusion, hallucinations or an irregular heartbeat. If you're going to the hospital for another reason, tell them how much you drink so they can watch for withdrawal.