Getting help for alcohol, drug or gambling problems in Spain

Terms used

• Tarjeta sanitaria — The tarjeta sanitaria is the regional public health card that gives you access to public health care.
• CAD — A CAD (Centro de Atención a las Adicciones) is a public addiction treatment centre run by a region.
• UAD — A UAD (Unidad de Atención a Drogodependientes) is a public unit that treats drug dependence.
• CAID — A CAID is another regional name for a public addiction care centre.

Key rules

• Self-referral: Most public addiction centres let you book an intake appointment yourself, without a GP referral.
• Cost: Public addiction treatment is generally free, but some regions charge part of long therapeutic-community stays.
• No health card: Ask the local centre first, as each region decides whether it sees you without a tarjeta sanitaria.
• Support groups: Anonymous groups are free, and English-language meetings are mostly in tourist areas and online.

Start with your region's public addiction centre

Public addiction centres and associations offer free or low-cost specialist help, and you reach them through your region's own network. Each region runs its own centres, so names and entry steps differ. You may see CAD, UAD, CAID or a similar name. To find yours, search your region's health service website or ask at your local health centre or town hall.

How to get in

Most centres let you call or walk in yourself. You usually do not need a GP referral. Some regions also take referrals from a GP, a hospital, social services or a court, but that is an extra route, not a requirement.

The first step is an intake assessment with a social worker or clinician. After that, you agree a treatment plan with them. The plan may include outpatient care, detox or a stay in a therapeutic community.

What it costs

Treatment in public centres is generally free for you. That covers consultations, psychological care and medication such as methadone. There are two exceptions. Some regions charge part of the cost of long stays in therapeutic communities, which are often funded through public contracts or NGOs. And private centres charge fees. Ask about any charge before you agree to a residential stay.

If you have no health card

Whether you can be seen without a tarjeta sanitaria is decided by each region. Many public addiction services, especially in cities, accept people without one for a first assessment and for harm-reduction services. Phone the local centre or your regional health service and ask before you go.

If you are an EU visitor, bring your European Health Insurance Card. It covers medically necessary care, but longer treatment may need you to register.

If you live in Spain and want a health card for wider care, such as other mental health services, you normally need to be registered at your town hall and assigned to a health centre. The rules for that are on the health-care pages.

Peer-support groups

Free peer groups work alongside the public centres, or instead of them if you prefer.

• Alcohol: Alcohólicos Anónimos has meetings across Spain, listed by province on its national site. Al-Anon supports families.
• Drugs: Narcóticos Anónimos has mostly Spanish meetings and some in English, with a meeting finder on its national site.
• Gambling: Jugadores Anónimos España runs gambling groups. Gam-Anon supports families. FEJAR is another gambling association.
• Regional groups: Many regions also have associations of rehabilitated alcoholics.

English-language meetings are concentrated in tourist areas such as the Costa del Sol, Alicante, the Balearics, the Canaries, Barcelona and Madrid. Online English meetings exist for all of these groups. Meeting times and places change, so check the group finder before you go.

The checklist below walks you through the steps, and the questions underneath answer the common doubts.

Checklist

• Find your region's public addiction centre, which may be called a CAD, UAD or CAID, through your regional health service or town hall.

• Call or visit the centre and ask for an intake appointment; you can usually do this yourself without a GP referral.

• Attend the intake assessment with a social worker or clinician, then agree a treatment plan with them.

• Ask the centre whether it will see you without a tarjeta sanitaria, at least for a first assessment.

• Bring your European Health Insurance Card if you are an EU visitor, and ask whether longer treatment needs registration.

• Find an Alcohólicos Anónimos, Narcóticos Anónimos or Jugadores Anónimos meeting through the group finder on its national website.

• Check the meeting time and place in the group finder before you go, as they change.

• Look for English-language meetings in tourist areas or online if you do not speak Spanish.

• Share the Al-Anon or Gam-Anon family groups with relatives who want support.

Frequently asked questions

Do I need a GP referral to get addiction treatment?

No, most public addiction centres let you call or walk in yourself, without a GP referral.

Is addiction treatment free in the public system?

Yes, treatment in public addiction centres is generally free, including consultations, psychological care and medication such as methadone.

Can I use public addiction services without a health card?

Often yes, many public addiction services, especially in cities, see people without a tarjeta sanitaria for a first assessment and harm-reduction help. Each region decides, and longer treatment may need registration.

Are there English-language support groups for alcohol, drugs or gambling?

Yes, Alcohólicos Anónimos has English-language meetings in tourist areas such as the Costa del Sol, Alicante, the Balearics, the Canaries, Barcelona and Madrid. Online English meetings also exist for the alcohol, drug and gambling groups and for family groups.