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 or 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 into 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

If your alcohol consumption is severe, or you have suffered from seizures or hallucinations due to alcohol withdrawal, your doctor may recommend inpatient alcohol detoxification.
When receiving inpatient medical or psychiatric services at Houston Methodist, your doctor may refer you to a chemical dependency counselor for referrals to appropriate outpatient or residential substance use treatment programs. 

Please note that Houston Methodist does not provide inpatient opioid detoxification, outpatient substance use treatment or residential substance use treatment. Once you have been evaluated by a chemical dependency counselor, you may be provided referrals to substance abuse treatment programs in the community.  

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

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.