Substance Abuse

Substance abuse is an addictive disorder characterized by the use of chemicals (drugs or alcohol) and the inability to stop using them despite all the problems they cause. Alcohol is the most common legal drug of abuse, but opioids (also called opiates or narcotics and obtained with or without a prescription) are widely misused.
Causes of Substance Abuse
Multiple factors can cause substance-related disorders, including genetic vulnerability, environmental stressors, social pressures, individual personality characteristics and psychiatric problems. The primary factors vary from person to person and can influence the drug or drugs of choice for each individual. Substances frequently abused include, but are not limited to, chemicals that alter moods or create a high such as:
  • Alcohol
  • Marijuana
  • Hallucinogens
  • Cocaine
  • Amphetamines
  • Opiates
  • Anabolic steroids

Types of Substance Abuse
The terms “abuse” and “dependence” are used in very specific ways to define the degree or intensity of substance-related disorders.

Substance abuse is the use of illegal substances or the misuse of legal substances. Substance abuse has certain characteristic patterns: 
  • Substance (drug) use leading to significant problems or distress, such as failure to attend work/school
  • Substance use in dangerous situations (driving a car)
  • Substance-related legal problems
  • Continued substance use that interferes with friendships and or family relationships
Substance dependence, also called chemical dependence, is the continued use of drugs or alcohol, even when significant problems related to their use have developed. Signs of dependence are different from those of abuse:
  • Increased tolerance or need for increased amounts of substance to attain the desired effect
  • Withdrawal symptoms with decreased use
  • Unsuccessful efforts to decrease use
  • Increased time spent in activities to obtain substances
  • Withdrawal from social and recreational activities
  • Continued use of substance, even with the awareness of physical or psychological problems

Symptoms of Substance Abuse
Individuals exhibit common behaviors when dealing with substance abuse. Each individual, however, may experience symptoms differently, and some of the symptoms of substance abuse resemble other medical problems or psychiatric conditions. Symptoms may include:
  • Getting high on drugs or getting intoxicated (drunk) on a regular basis
  • Telling lies, especially about how much they are using or drinking
  • Avoiding friends and family members
  • Giving up activities that were once enjoyable, such as sports or spending time with non-using friends
  • Talking a lot about using drugs or alcohol
  • Believing they need to use or drink to have fun
  • Pressuring others to use or drink
  • Getting in trouble with the law
  • Taking risks, such as sexual risks or driving under the influence of a substance
  • Decreased work performance due to substance abuse before, after, or during working or business hours
  • Missing work due to substance use
  • Depressed, hopeless or suicidal feelings

Certain physical signs of substance use are often apparent, including:
  • Fatigue
  • Poor hygiene
  • Red eyes
  • Weight loss

Diagnosing Substance Abuse
Your doctor will perform a physical exam and obtain a medical and social history. In addition, a careful psychiatric evaluation will be conducted. Blood, urine or other laboratory tests may be used to assess drug use.
Treating Substance Abuse
Houston Methodist’s psychiatric specialists will work with you to develop an individualized course of treatment after determining specific information pertaining to substance abuse, including:
  • Your age, overall health and medical history
  • Extent of your symptoms
  • Degree of your dependence
  • Type(s) of substance(s) you use
  • Your tolerance for specific medications, procedures or therapies
  • Your expectations for the course of the condition
  • Your opinion or preference

A variety of substance abuse treatment programs are available at Houston Methodist on both inpatient and outpatient bases.
  • A detoxification program for the abused substance may be recommended. Long-term follow-up management usually includes formalized group meetings and age-appropriate psychosocial support systems, as well as continued medical supervision.
  • Psychotherapy (individual and family) is needed to address the developmental, psychosocial and family issues that may have contributed to and resulted from the development of a substance abuse disorder. Family-focused prevention programs involve parent training, family skills training, children's social skills training and family self-help groups
The healthcare professionals at Houston Methodist support and cooperate with school-based prevention programs. Drug and alcohol education, interpersonal and behavior skills training, and community-based prevention programs, are provided in conjunction with the media, parents and community groups, such as Mothers Against Drunk Driving (MADD) and Students Against Drunk Driving (SADD).
Increased Risk of Suicide
Suicide is a serious issue in individuals with substance abuse. Certain indications or efforts toward plans to commit suicide require intervention:
  • Saying "I want to kill myself" or "I'm going to commit suicide"
  • Verbal hints, such as "I won't be a problem much longer" or "If anything happens to me, I want you to know..."
  • Giving away favorite possessions or throwing away important belongings
  • Becoming suddenly cheerful after a period of depression
  • Expressing odd or bizarre thoughts
  • Writing a suicide note

Threats of suicide communicate desperation and a cry for help. Always take statements of suicidal feelings, thoughts, behaviors or plans very seriously. If possible, do not leave the person alone. Contact a mental health professional and/or call 911 immediately.


Our physicians at Houston Methodist specialize in treating substance abuse at the following convenient locations