How We Calculate the Free Resource Score

The Free Resource Score is a 0 to 10 rating that shows how easy it is to find free and low-cost addiction help in a given county. It draws on public data about treatment capacity, state coverage and laws, local costs, and harm reduction access, plus our own first-hand research. It measures access to affordable help, not the clinical quality of any single program, and a lower score never means no help exists.

For a lot of people, the hardest part of getting help for addiction is money. Before choosing a program, they need to know what they can actually afford. The Free Resource Score speaks to that worry directly. It is a single 0 to 10 number, shown on every city and county page, that tells a person how much free and low-cost help is within reach where they live.

What the Free Resource Score is (and is not)

The Free Resource Score is an access signal. It answers a practical question: in this county, how easy is it to find addiction help that a person can get for free or at low cost, including care paid for by Medicaid or offered on a sliding scale?

The score is calculated at the county level. Every city page within a county shows the same overall number, because the free safety net (public treatment programs, Medicaid coverage, harm reduction supplies, sliding-scale clinics) is organized mostly at the county and state level rather than city by city. The editorial write-up and the specific resources listed below the score are what change from one city to the next.

The score does not rate the quality of any single treatment program. A high number does not promise a good experience at a particular clinic, and it makes no claim about outcomes. It reflects how many affordable doors are open in an area, not what happens after a person walks through one. A low number does not mean help is unavailable either. It means fewer free options are based locally, so state helplines, Medicaid, naloxone by mail, and nearby cities carry more of the weight.

How to read the score

Every score sits on a 0 to 10 scale. Rather than memorize a cutoff, it helps to read the number as a band:

Underneath the overall number sit four category ratings. Each one describes a different part of the picture, and together they explain why a county earned the number it did. Two counties can land on the same overall score for very different reasons, so the categories are worth reading, not just the headline number.

The four categories behind the score

Here is what each category covers and roughly how much it counts toward the overall number. We publish the categories and their broad weights, not the exact point math behind them.

Treatment availability

This category looks at how much affordable treatment is around, weighed against local need. An area with many publicly funded and sliding-scale programs relative to how hard it has been hit by overdoses rates higher than an area with the same number of programs but far greater need.

Ratings run from Strong and Good (a relatively deep set of options for the area) to Moderate (a workable set, though not deep) and Limited (fewer local options, so statewide programs and nearby cities matter more).

The underlying data comes from CDC WONDER overdose mortality figures, treatment facility counts published by SAMHSA, and our own rehabs.org directory of programs.

Coverage and legal support

State policy shapes how easy it is to get free or low-cost help, so this category looks at five things: whether the state expanded Medicaid, whether syringe services are legal, whether a naloxone standing order lets people get the overdose-reversal medication without an individual prescription, whether fentanyl test strips are legal, and whether a Good Samaritan law protects people who call 911 during an overdose.

Ratings run from Strong and Good down through Mixed and Limited. When a county is not rated Strong, the page names the single most important gap in plain language. The most common one is a state that has not expanded Medicaid, which directly narrows who can get covered care.

Sources include KFF for Medicaid expansion status, the Legislative Analysis and Public Policy Association and the Network for Public Health Law for syringe services, test strips, and Good Samaritan statutes, and state health departments for naloxone standing orders.

Local cost of care

This category compares the general cost of services in an area with the national average, using the U.S. Bureau of Economic Analysis Regional Price Parities. It is rated Lower than average, About average, or Higher than average.

Local prices matter for people paying out of pocket, but the free paths on every page do not depend on them. Medicaid, sliding-scale clinics, and no-cost programs are the $0 route whether an area is expensive or cheap. For that reason this category counts for less than treatment availability, and we do not publish a dollar estimate for the cost of treatment in any given city.

Harm reduction access

Harm reduction saves lives, and it is a valid point of entry for people who are not ready for or not interested in abstinence-based treatment. This category looks at whether naloxone, fentanyl test strips, and syringe services are reachable in an area.

Ratings are Active (a syringe services program or several concrete services are present), Available (at least one concrete service), and Few listed. We use Few listed rather than “none” on purpose. Our harm reduction census is a conservative count, so a thin rating reflects what we have confirmed so far, not proof that nothing exists. Wherever the local rating is thin, the page points to statewide naloxone that can be ordered by mail and to our guide on getting free naloxone.

This category draws on the North America Syringe Exchange Network directory and our own rehabs.org harm reduction census.

What scores mean

Because the score packs four categories into one number, it helps to know what different points on the scale tend to look like.

• A 9 means all the major pieces are in place and the region has excellent options: treatment capacity that keeps up with local need, supportive laws and Medicaid, affordable local costs, and active harm reduction. In a place like this, cost should rarely be the thing that stops someone from starting.
• A 7 usually means above-average access with one or two weaker points. It is a strong starting point, with most of what a person needs close by.
• A 5 usually means a real but thinner local safety net. The pieces exist, but statewide helplines and nearby cities carry more of the load, and it is worth casting a slightly wider net.

Two counties can share the same 7 for opposite reasons. One might have Strong treatment availability but only Few-listed harm reduction. Another might have Active harm reduction and Strong coverage alongside Higher-than-average local costs. The overall number tells you roughly how open the door is.

The four category ratings tell you where the strengths and gaps are, which is why we show them side by side. And a lower overall number never means help is out of reach. It means fewer local free options, while state helplines, Medicaid, mail-order naloxone, and nearby cities remain available.

Where our data comes from

The score is built from public, authoritative data and from our own original research. We name every source so anyone can check the work.

• CDC WONDER, for overdose mortality data (cdc.gov)
• SAMHSA, for the national treatment locator and behavioral-health facility data (samhsa.gov)
• KFF, the Kaiser Family Foundation, for Medicaid expansion status by state (kff.org)
• The Legislative Analysis and Public Policy Association, for syringe services, fentanyl test strip, and Good Samaritan statutes (legislativeanalysis.org)
• The Network for Public Health Law, for naloxone and Good Samaritan law (networkforphl.org)
• The U.S. Bureau of Economic Analysis, for Regional Price Parities (bea.gov)
• The North America Syringe Exchange Network, for its syringe services directory (nasen.org)
• The rehabs.org editorial directory and harm reduction census, our own first-hand research rather than scraped listings

That last item matters for accuracy. Our harm reduction census is compiled by hand from official and organization-run sources, which is slower than pulling from an aggregator but far more reliable for the kind of contact detail a person needs in a hard moment.

How we keep the score accurate, and where it falls short

We revise the score as the underlying data updates and as we confirm 3rd party resources by hand. Public sources like CDC WONDER, SAMHSA, and the Bureau of Economic Analysis release on their own schedules, and we refresh the score when new figures are available. Each version carries a date so a reader can see how current it is.

Two limits are worth stating:

First, our harm reduction census is a conservative floor. We would rather undercount services than list one that has closed or moved, so a rating of “Few-listed” often reflects the limits of what we have been able to confirm and verify, not the full reality on the ground.

Second, the score describes access to free and low-cost help, and nothing in it measures the quality of care at a specific program.

If something on a score page looks wrong, out of date, or missing, please contact us and let us know.

Who builds and reviews this

This methodology is maintained by the rehabs.org editorial team and reviewed for clinical and public-health accuracy before publication. Our editorial standards for this work are thorough. Every phone number and web address is traced to an official first-party source, a government (.gov) page or the organization’s own site, before it goes on a page.

Editorial independence

The free resource layer on rehabs.org is editorial. The public programs, nonprofits, harm reduction services, and support groups that feed the score are chosen and rated on the merits, not because anyone paid for placement. Advertising and paid listings, where they appear elsewhere on the site, are kept separate from this scoring and do not influence it. Harm reduction is included because the clinical evidence supports it.

If you need help right now

If you or someone you care about needs help right now, you do not have to wait for a score.

• Call or text 988 to reach the 988 Suicide and Crisis Lifeline, free and available 24 hours a day.
• Call the SAMHSA National Helpline at 1-800-662-4357 for free, confidential referrals to treatment and support, available 24/7 in English and Spanish.

From any city page you can also reach your state’s directory and helplines, along with the pages for nearby cities, which list local programs next to the same statewide resources. To browse the full directory, start at our treatment centers directory.

Last updated: July 28, 2026
Method version: 1.0
What changed: This is the first published version of the Free Resource Score methodology. Future revisions and a short summary of what changed will be listed here.