Google – Please Do Not Make The SAMHSA Big Box Result Permanent


When a person looks for answers to their addiction problem in Google’s search engine they are presented with many options. Options both helpful and not as helpful. The recent change that Google has made to search results for terms related to drug rehab is not helpful.

The Change

On 05/27/2020 a new notice appeared on desktop searches related to addiction treatment search terms such as “Drug rehab” “Alcohol rehab “Treatment centers” etc. I took this screenshot as soon as I noticed the change. This is the desktop result. A similar result occurs in mobile searches. As of the date of this article, (05/29/2020) the change does not seem to be rolled out to everyone on all devices and locations. I am seeing it consistently on a desktop in Washington State. My colleagues are also seeing it on mobile and some are not seeing this at all. I hope this is only a test and will be rolled back.

An image of Google Big Box SAMHSA Hotline result.
A screenshot of the Big Box SAMHSA Hotline Google result

What Does This Mean for the Searcher?

This result is large and in charge. It takes up nearly the entire screen real estate on a desktop search with no organic or local search results visible above the fold. This could easily garner 50% or more of the clicks within these queries ( The next three spots are paid ads. These paid positions are being pushed down to only two or three visible ads.

For the searcher, they are presented with fewer options. Fewer options for help when faced with a life or death situation – getting help for addiction. Whether the searcher is a loved one or the person suffering the SAMHSA hotline is not the best search result.

To be included in SAMSHA a treatment center must meet the following requirements as described on this page:



Substance Use Treatment Facility – The facility must provide substance use treatment services to persons with substance use or addiction. One of the following must apply:

  • The facility has licensure/accreditation/approval to provide substance use treatment from the state substance use agency or a national accrediting body (e.g., The Joint Commission, CARF, NCQA, etc.).
  • The facility has staff who hold specialized credentials to provide substance use treatment services.
  • The facility has authorization to bill third-party payers for substance use treatment services using an alcohol or drug client diagnosis.


This prevents any facility that may not be licensed (alternative, religious, progressive, community based) from being listed on SAMHSA. This places the control of treatment center “approval” in the hands of a single government agency.

What Is the Experience of Contacting SAMHSA?

I have contacted SAMHSA hundreds of times in my career as a marketing executive for treatment centers. If you call SAMHSA they simply ask a scripted series of questions:

  • Where are you located?
  • Is this for substance use or mental health?
  • Is this for a loved one or Yourself?
  • Are you looking for short or long term treatment?
  • What is your insurance coverage?

That is all they ask. Then they simply direct you to the same list of results you would have found had you used their treatment finder located at They will now text you the results as well if you ask.

This Presents Several Problems

  1. It limits results for searches to a government-led directory
  2. It further suppresses alternative treatment options including non-12 step, faith-based, educational, or community-based programs
  3. The folks who answer at SAMHSA are not licensed. Many treatment centers have licensed counselors that answer the phone or are available when a phone assessment is needed
  4. Being listed in SAMHSA requires a treatment center to proactively fill out the paperwork to do so. SAMHSA does not list all treatment centers – only ones who have applied and been accepted according to their criteria and who participate in their annual survey
  5. It limits results to only facilities that have third party insurance billing authorization. This eliminates self-pay facilities or organizations that may treat addiction differently than mainstream disease model/medical-based models.

Why Would Google Make This Change?

Since 2017 Google has been fighting webspam in the addiction treatment space ( A big move was the temporary elimination of paid ads in 2017 for treatment centers. Google began allowing ads again through a third party gatekeeper – Legistscript certification. Admittedly spam has been a problem in this space.

Additionally, Google has been manually inserting the SAMHSA website as the #1 organic position since about the same time. This practice seems to have now been replaced with the big box SAMHSA result. I have not heard from Google nor do I have inside information but in my opinion, this change to the big box was made by Google for a few reasons.

  1. It reduces their liability by providing what at first glance appears to be a neutral, vetted resource for addiction treatment centers
  2. Google believes it cannot control webspam in its results. This is a band-aid to solve problems they cannot fix through algorithm updates
  3. Google does not understand the treatment space and the many paths to recovery promoted by ASAM
  4. Google believes that individual treatment centers and directories do not offer unbiased treatment advice
  5. Google is getting advice from biased old-school treatment centers and thinkers (

I implore Google to stop providing this result for addiction treatment terms. The decision puts people suffering from addiction and looking for help at a disadvantage. They cannot find true local results in their area. This decision also limits the free market within the treatment space. It suppresses many small, alternative, faith-based, or progressive treatment centers.

What You Can Do

If you agree and do not like the result you can give feedback to Google stating your opinion. Do your search and scroll to the bottom of the page and click “Send feedback”. Highlight the result you do not like and click send. If enough people do this maybe Google will get the message and remove this big box forever.

A Screenshot of Google's report feedback dialog box.
Google send feedback dialog box located at the footer of every Google search result page.