How to get Suboxone (buprenorphine) treatment in Texas

Overdose risk is highest after a break from opioids, such as after detox, jail or a hospital stay. Keep naloxone nearby: see free Narcan in Texas. In an emergency call 911; in a crisis call or text 988. SAMHSA's National Helpline, 1-800-662-4357, is free and open 24/7.

Where you can start

Where	How it works	Good to know
Your own doctor or clinic	A primary care doctor, NP or PA evaluates you and sends a prescription to your pharmacy	No waiver is needed any more, so ask even if they've never prescribed it
An addiction treatment program	Its prescriber manages the medicine while you attend counseling, IOP or outpatient care	Ask whether they prescribe it themselves or work with a prescriber who does
An opioid treatment program (methadone clinic)	The clinic can dispense buprenorphine as well as methadone	Visits are more frequent at first; see how methadone clinics work
Telehealth	A prescriber evaluates you by video or phone and sends the prescription to a pharmacy	Allowed under DEA rules; see telehealth below

Who can prescribe it now

• No more X-waiver. Section 1262 of the Consolidated Appropriations Act, 2023 (the MAT Act) ended the special federal waiver and the cap on how many patients a clinician could treat. A standard DEA registration with Schedule III authority is enough, where state law allows.
• One-time training. The MATE Act requires prescribers to attest to 8 hours of training on substance use disorders when they apply for or renew their DEA registration. Addiction medicine and addiction psychiatry specialists are deemed to meet it.
• Nurse practitioners and PAs in Texas prescribe under a prescriptive authority agreement with a physician (Occupations Code chapter 157). Schedule III to V medicines can be delegated, which covers buprenorphine.
• Texas prescribers must check the prescription monitoring program before prescribing an opioid, and buprenorphine is an opioid (Health and Safety Code 481.0764). That's a routine safety step, not a sign of suspicion.

One change makes prescribers harder to find: SAMHSA's old buprenorphine prescriber locator is gone, and individual prescribers are no longer searchable on FindTreatment.gov. Treatment facilities are still listed, and so are the programs on Cima Find Care.

Suboxone by telehealth in Texas

• The buprenorphine telemedicine rule. A DEA rule in effect since December 31, 2025 lets a clinician prescribe buprenorphine for opioid use disorder by telemedicine, including audio-only, for up to six months before an in-person evaluation is needed.
• The broader flexibilities. DEA and HHS extended the pandemic-era telemedicine flexibilities for controlled substances through December 31, 2026.
• The prescriber must be licensed in Texas to treat you in Texas, and you fill the prescription at a pharmacy.

Telehealth rules for controlled substances have changed several times. Ask the prescriber how they'll handle in-person visits if the rules change.

Your first visits

1. An evaluation: your opioid use, health, other medicines and goals. Expect a urine drug test.
2. Starting the medicine. Buprenorphine can bring on sudden withdrawal if other opioids are still active in your body, so your prescriber will tell you how long to wait after your last use, or use a different way of starting. Follow their plan, especially if you've used fentanyl or methadone.
3. Follow-up visits are close together at first, then spread out once your dose is steady.
4. Counseling helps, and many programs offer it alongside. Medicine and counseling together is how NIDA and SAMHSA describe treatment for opioid use disorder.

Buprenorphine comes as a film or tablet under the tongue (alone or with naloxone, as in Suboxone) and as long-acting injections given by a clinician. Ask which forms your plan covers.

Does Texas Medicaid or insurance cover it?

Coverage	What to know
Texas Medicaid	Medication-assisted treatment is part of Texas Medicaid's substance use benefit, with no copays. The medicine goes through the Vendor Drug Program; some buprenorphine products need a clinical prior authorization, which the prescriber requests. Check a product at txvendordrug.com, or ask your health plan.
Medicare	Part D drug plans cover prescriptions you fill at a pharmacy. Part B covers opioid treatment program services, paid to the program as a weekly bundle that includes the medicine and counseling.
Private and Marketplace plans	Substance use treatment is an essential health benefit for Marketplace and small-group plans, and the federal parity law keeps a plan's rules for it from being stricter than for medical care. Call your plan about the drug's tier, prior authorization and in-network prescribers.
No insurance	Texas HHSC pays for treatment, including medication, for Texans whose income qualifies. Start with your regional OSAR: call 2-1-1. See free and state-funded rehab in Texas.

More on coverage: does insurance cover rehab? and Texas treatment by insurance plan.

Buprenorphine, methadone and naltrexone

	Buprenorphine (Suboxone)	Methadone	Naltrexone (Vivitrol)
Who can give it	Any prescriber with a DEA registration covering Schedule III; also opioid treatment programs	Only a certified opioid treatment program, for opioid use disorder	Any licensed prescriber; it isn't a controlled substance
Where you get it	A pharmacy, or the clinic for injections	The clinic, with take-home doses as you progress	A pharmacy (tablet) or the clinic (monthly injection)
Before starting	Usually some withdrawal first, as your prescriber directs	No wait needed	You must be off opioids first
Also treats alcohol use disorder	No	No	Yes

Find a program that offers it

Counted from the Texas programs on Cima Find Care. "MAT" means the program offers medication for addiction treatment, which can be buprenorphine, methadone or naltrexone; call to ask which.

Level of care	Programs in Texas	Accept Medicaid	Accept Medicare	Accept private insurance	Sliding-scale fee
MAT (medication)	168	111	88	147	45

Counted from Cima Find Care's Texas records as of 2026-10-27: one program per organization, so an organization in several cities counts once (city by city, it counts in each), from SAMHSA's FindTreatment.gov and the programs' own websites. A program counts when any of its locations lists it.

City	MAT (medication)
Austin	10 programs, 6 take Medicaid
Dallas	18 programs, 15 take Medicaid
El Paso	5 programs, 4 take Medicaid
Fort Worth	7 programs, 4 take Medicaid
Houston	22 programs, 13 take Medicaid
San Antonio	14 programs, 10 take Medicaid

More cities: Arlington, Frisco and Lubbock, or every Texas city. Not sure what level of care you need? Answer four quick questions.