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Drug & alcohol use

Get help for addiction at Substance Use Therapy in Austin, TX

For many people, using drugs and alcohol begins quite logically—you do it because it feels better than when you don’t.  That’s the upside.  The downside is that it often leaves other issues unresolved. 


In many cases, the substance use itself stops being helpful and begins to create new issues.  I incorporate a strengths-based approach to support you and help you define your goals. 

Substance use can be stressful and you do not have to manage it alone.

Substance use disorder definition

Although we use words like alcoholism and  addict frequently, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) does not use these words in relation to drugs and alcohol.  They use the terms substance use disorder and alcohol use disorder and include a range of severity: mild, moderate and severe. 

Harm reduction practitioners often favor the term substance misuse to talk about substance use that has become problematic. Misuse is more neutral than ‘abuse’ and it avoids the stigma that can be associated with the word ‘disorder’.

What are the signs and symptoms of a substance use disorder?

The DSM lists 11 criteria. Experiencing 2 or more in a 12-month period may indicate a substance use disorder.

  1. Substance taken in larger amounts or over a longer period

  2. Efforts to cut down or control use are unsuccessful

  3. Cravings

  4. Continued use despite negative consequences

  5. Failure to fulfill obligations at home, work or school

  6. Continued use despite experiencing social/interpersonal problems due to substance use

  7. Giving up on enjoyable activities due to use

  8. Ongoing substance use in situations that are risky/dangerous

  9. Continued use despite knowledge of having a physical/psychological problem that is caused by the substance, or worsened by it

  10. Tolerance

  11. Withdrawal

What are the signs and symptoms of an alcohol use disorder?

The DSM lists 11 criteria.  Experiencing 2 or more in a 12-month period may indicate an alcohol use disorder.

  1. Drinking larger amounts or for a longer period than intended

  2. On more than one occasion feeling the need or unsuccessful attempts to cut down or stop drinking

  3. Spending a lot of time drinking or recovering from the effects of alcohol

  4. Craving or thinking about wanting a drink, or having a strong urge to use alcohol

  5. Failing to fulfill major work, school, or home responsibilities due to drinking

  6. Continuing to drink even though it is causing relationship troubles with your family or friends

  7. Important activities (social, work, school, hobbies) are given up or reduced due to alcohol use

  8. Drinking before or during situations that are physically dangerous—while driving a car, operating machinery, swimming, or having unsafe sex

  9. Continuing to drink even though drinking is making you feel depressed or anxious, is linked to another health problem, or results in having memory blackouts

  10. Developing a tolerance for drinking—needing much more than you once did to get the desired effect from alcohol, or not experiencing the same effect when drinking the same amount of alcohol

  11. Withdrawal, as characterized by having withdrawal symptoms (trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or hallucinations

How Substance Use Therapy in Austin can help you

Most people who struggle with issues related to alcohol and drugs are ambivalent about making a change.  All too often, this is viewed as a lack of motivation or an assumption that someone hasn’t “hit bottom” yet.  I believe ambivalence is normal and exploring that ambivalence together should that be a natural part of therapy. 


Assuming someone needs to get much worse before they can get better is dangerous.  We would never say that about a physical problem, so why would we say it about substance use?

I work collaboratively to understand you and the role that alcohol and/or drugs plays in your life.  We will work together to identify ways to minimize harm caused by use.  Then, we will develop ways to implement changes—at a pace that works for you.

What if I have issues other than substance use?

Then you are like the rest of us!  Rarely do we ever have one problem.  You may use drugs and alcohol, but feel other issues are more pressing.  Where we begin and where we place most of our focus is up to you. 


For example, you might feel your drinking is an issue, but you want to first focus on issues such as anxiety or depression.  For any treatment to be successful, it has to be right and meaningful for you.

Some people with substance use issues choose to participate in couples or family counseling.  This could be your primary treatment or something you add once in a while for additional support.

What if I need medication to help me stop using?

Medications are considered another form of harm reduction.   Examples might include methadone maintenance, buprenorphine, and naltrexone. 


If you are already working with a prescriber, you may find attending separate therapy provides additional support.  If you are interested in getting more information on medications to help with alcohol or opioid dependence, resources and referrals can be provided.


Who is Substance Use Therapy for?

Anyone in any stage of use.  It is okay if you are still using, aren’t sure if you want to quit or are just looking for an alternative to traditional treatments to drugs and alcohol. 


Just like substance use is individual, and on a continuum, your treatment should be too.  Whether you are looking for complete abstinence or moderation and safer practices, you are welcome here. No shame, no judgment.  Just support.

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