Your Chances of Getting Addiction Treatment Depend More on Your State Than Your Addiction

Georgia has the worst addiction treatment access rate in America.

According to a new analysis of federal treatment facility and substance use data, the state has just 35 addiction treatment facilities serving an estimated 1.83 million residents living with a substance use disorder.

That works out to just 1.9 facilities for every 100,000 people in need — the lowest rate in the country.

The findings come from a state-by-state study by Siegfried & Jensen, which compared the number of addiction treatment facilities listed in the 2025 SAMHSA National Directory of Mental Health Treatment Facilities against federal estimates of how many people in each state are living with a substance use disorder.

The results reveal enormous disparities in access to treatment across the United States.

North Dakota ranked first in the nation, with 565 treatment facilities per 100,000 people with a substance use disorder.

The gap between North Dakota and Georgia is 296-fold.

Researchers say the figures expose a treatment system that bears little resemblance to the actual scale of addiction across the country.

The States Falling Furthest Behind

Georgia is not alone.

Several of America’s largest states ranked among the worst in the country for treatment access.

North Carolina has 40 facilities serving nearly 1.8 million people with a substance use disorder, giving it a ratio of just 2.2 facilities per 100,000 people in need.

California, which has an estimated 6.6 million residents living with a substance use disorder, has only 208 treatment facilities.

Florida has 232 facilities serving approximately 3.6 million people.

Pennsylvania, Wisconsin, South Carolina, New Jersey and Ohio all ranked among the bottom-performing states.

The findings challenge a common assumption that wealthier or more populated states automatically provide better access to treatment.

Connecticut, one of the wealthiest states in the country, also ranked in the bottom ten.

America’s Hidden Treatment Crisis

The analysis comes as substance use continues to affect millions of Americans.

Federal data shows that 48.3 million Americans — approximately 16.8% of the population aged 12 and older — are living with a substance use disorder.

Yet fewer than 14,000 treatment facilities exist nationwide.

Researchers argue that the treatment gap is often overlooked because discussions around addiction tend to focus on overdose deaths rather than treatment availability.

But for many people seeking help, access to care can be the first obstacle.

In some areas, that means waiting lists.

In others, it means travelling long distances to find an available bed.

For some, it means no treatment at all.

The States Getting It Right

While much of the country struggles with access, several states have built significantly stronger treatment infrastructure.

North Dakota ranked first, followed by Alaska, Delaware, Vermont and New Mexico.

Researchers found these states have maintained treatment capacity far more closely aligned with the number of people needing support.

Arkansas also ranked among the best-performing states despite not typically being considered a leader in healthcare infrastructure.

The contrast with larger states was stark.

Florida has roughly fourteen times more people living with a substance use disorder than Arkansas, yet Arkansas has dramatically more treatment facilities.

A Crisis Measured in Geography

The findings suggest that where a person lives may be one of the strongest predictors of whether treatment is available when they need it.

The difference between Georgia and North Dakota is not simply statistical.

It represents the difference between having hundreds of potential treatment options nearby and having almost none.

As addiction continues to affect nearly one in six Americans, researchers say the question is no longer whether the country has a substance use problem.

The question is whether it has built enough places to treat it.