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Sponsored| Name | Address | City |
|---|---|---|
| Center for Health Maintenance | 3251 Harry Wurzbach Rd. | San Antonio |
| Crisis Care Center | 601 North Frio Street | San Antonio |
| Serenity Oaks Center – San Antonio Suboxone Clinic | 5368 Fredericksburg Rd Building C. Suite 100 | San Antonio |
| Lifetime Recovery Treatment Center – Lifetime Recovery Treatment | 96 Crossroads Boulevard | San Antonio |
| New Season Treatment Center – NW San Antonio | 3615 Culebra Rd | San Antonio |
| MedMark Treatment Centers San Antonio Quincy | 519 E Quincy St | San Antonio |
| New Season Treatment Center – San Antonio | 3701 West Commerce Street | San Antonio |
| MedMark Treatment Centers San Antonio | 7428 Military Drive West Suite D | San Antonio |
| The Center for Health Care Services | 601 N. Frio | San Antonio |
| River City Rehabilitation Center | 680 Stonewall St | San Antonio |
| MedMark Treatment Centers San Antonio Quincy | 519 E Quincy St San Antonio | San Antonio |
| Stop SA | 571 Spencer Lane Suite 101 | San Antonio |
| VCPHCS VII, LLC | 1701 North St. Mary Street | San Antonio |
| Medmark | 7424 Military Dr W | San Antonio |
| Be Well Texas | 5109 Medical Dr | San Antonio |
| Rivercity Rehab | 1149 S Academy Ave | New Braunfels |
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Medication treatment for opioid use disorder in San Antonio
San Antonio is a large metro where both kinds of medication treatment for opioid use disorder (OUD) are within reach: opioid treatment programs (OTPs, the clinics that dispense methadone) and office-based prescribers who handle buprenorphine and naltrexone. That means you have real choices in Bexar County about which medication you take and how you receive it, whether you want the structure of a daily clinic or the flexibility of a prescription filled at a pharmacy. The listings on this page connect you to local providers, and the helpline can help you find a starting point if you are not sure where to begin.
Your three medication options, and the two places you get them
Three medications are approved to treat OUD, and they work in different ways. Methadone is a full opioid agonist that eases withdrawal and cravings; for OUD it is dispensed only through a licensed opioid treatment program, not a regular pharmacy. Buprenorphine, including Suboxone (a buprenorphine-naloxone combination) and the extended-release monthly injection Sublocade, is a partial agonist with a ceiling effect that lowers overdose risk. Naltrexone, including the monthly Vivitrol injection, blocks opioid effects entirely and is started only after you have been off opioids for a set time.
Setting is the other half of the picture. An OTP provides methadone on-site and can also offer buprenorphine and naltrexone. Office-based opioid treatment (OBOT) means a doctor, nurse practitioner, or physician assistant prescribes buprenorphine or naltrexone in a regular medical office, and you fill it at a pharmacy or by telehealth. If you are weighing the trade-offs, it helps to read how methadone and Suboxone compare before you call, then decide with a clinician which fits you.
Starting treatment: what the first visit looks like
Getting started begins with an intake assessment, where a provider reviews your history and, if medication is appropriate, plans your first dose (induction). Bring a photo ID and your insurance or Medicaid information if you have them, but not having them should not stop you from calling. If you have been using fentanyl, timing matters: starting buprenorphine too soon after fentanyl can trigger sudden, severe withdrawal (precipitated withdrawal), so a clinician will plan when your first dose is safe. Some San Antonio programs offer same-day or next-day intake. You can also read more about methadone treatment when fentanyl is involved as you prepare.
Take-home doses and telehealth under current rules
Federal rules updated in 2024 expanded take-home methadone, up to a 28-day supply for patients who are stable in treatment, on a graduated schedule that starts with fewer take-homes early on. The same update lets treatment begin by telehealth and authorized mobile medication units. Whether you qualify for take-homes is decided by your program based on how stable you are, so staying consistent with your dosing is what builds toward more flexibility. Buprenorphine can be started through telehealth, including by phone in many cases, without a prior in-person visit; those flexibilities run through the end of 2026 and are still being finalized, so confirm what is current with a provider. Methadone for OUD is still dispensed through an OTP.
Paying for treatment in Texas
In Texas, Medicaid is delivered mainly through STAR managed care plans run by the Health and Human Services Commission, and it covers all three OUD medications, methadone, buprenorphine, and naltrexone. Bexar County is one of the STAR service delivery areas, so local plans apply here. Texas has not expanded Medicaid, so many working adults do not qualify; if that is you, ask providers about private insurance, Medicare, self-pay rates, and sliding-scale fees. Some clinics also draw on federal SAMHSA block grant funding to serve people who cannot pay, so it is worth asking each program directly what it offers.
The overdose picture in Bexar County, and why it is turning
Bexar County recorded roughly 23 drug-overdose deaths per 100,000 residents in 2023, according to Texas Department of State Health Services data reported by the Texas Tribune, higher than the statewide average. There is real movement in the right direction: San Antonio’s Metropolitan Health District reported that opioid deaths, including those involving fentanyl, fell in 2024, which the city’s chief mental health officer attributed largely to wider naloxone availability. In November 2024, the San Antonio City Council declared overdoses a public health crisis to expand prevention and treatment. Behind those numbers are people who reached care, and effective medication treatment is available across the city right now. If you want the broader context, here is an overview of opioid use disorder and how it is treated.
Care for veterans, pregnancy, and the justice system
San Antonio, sometimes called Military City USA, has a large active-duty and veteran population, and OUD treatment is confidential; VA and community providers both offer MOUD, and starting or staying in treatment does not by itself jeopardize a security clearance or benefits. If you are pregnant, methadone and buprenorphine are the recommended standard of care, and treatment lowers the risk of harm to you and the baby; a care team can also plan for neonatal opioid withdrawal syndrome (NOWS) and a Plan of Safe Care. Seeking treatment is the protective step here. For people involved with drug court, probation, or reentry after incarceration, many programs can begin quickly and coordinate documentation. Families who want to understand how to help can start with this guide for loved ones.
Naloxone and overdose safety
Naloxone, the medication that reverses an opioid overdose (often sold as Narcan nasal spray), is available over the counter and at pharmacies across San Antonio, and free supplies are distributed by mail and in the community through Naloxone Texas and local organizations. One important detail: Texas has a naloxone access law that protects people who carry and give it, but unlike most states it does not have a Good Samaritan law shielding someone from drug-possession charges for calling 911 during an overdose. Call for help anyway; a life comes first. If you or someone you know uses opioids, keeping naloxone on hand is one of the most effective steps you can take, and a return to use is a manageable part of recovery, not a failure. Learn more about recognizing and responding to a methadone or opioid overdose.
Common questions about San Antonio treatment
Can I get same-day treatment in San Antonio?
Some OTPs and office-based providers offer same-day or next-day intake, though it varies by program and by day. Call the providers in the listings above or the helpline and ask directly about the soonest available assessment.
Do I have to go to a clinic every day for methadone?
At first, often yes. Methadone for OUD is dispensed at an OTP, and daily visits are common early in treatment. As you stabilize, federal rules allow take-home doses of up to a 28-day supply, decided by your program.
Is Suboxone or methadone better?
Neither is better for everyone. Methadone and buprenorphine are both effective; the right choice depends on your history, preferences, and what your clinician recommends. Naltrexone is a third option once you are off opioids. This is a decision to make together with a provider.
Will Medicaid cover my treatment?
Texas Medicaid, delivered through STAR managed care, covers methadone, buprenorphine, and naltrexone. Because Texas has not expanded Medicaid, eligibility is limited; if you do not qualify, ask about private insurance, Medicare, self-pay, and sliding-scale options.
Can I start buprenorphine by phone?
In many cases, yes. Current federal rules allow buprenorphine to be started by telehealth, including audio-only, without a prior in-person visit, through the end of 2026. Confirm what is available with the provider you choose.
Last reviewed and disclosures
Last reviewed July 2026.
Sources
- SAMHSA, medications for opioid use disorder and the 2024 update to 42 CFR Part 8, 2024 to 2026.
- DEA and HHS, buprenorphine telemedicine final rule and fourth temporary extension of telemedicine flexibilities, effective through December 31, 2026.
- Texas Health and Human Services Commission, STAR Medicaid managed care and covered MOUD.
- Texas Law Help, Texas Medicaid coverage of methadone, buprenorphine, and naltrexone, 2024.
- Texas Department of State Health Services drug-related deaths data, reported by the Texas Tribune, 2024 (2023 figures).
- Axios San Antonio, San Antonio Metropolitan Health District on the 2024 decline in opioid deaths, 2025.
- Network for Public Health Law, Texas naloxone access law and Good Samaritan status.
- Naloxone Texas, statewide naloxone distribution.
Methadone Centers is not a treatment provider and does not offer medical advice. The information here is educational and not a substitute for care from a licensed clinician.
The helpline on this site is sponsored. Calls may be answered by a paid advertiser among the treatment providers available.