Substance Use Disorders

If you or someone you care about is struggling to stop using a substance, help is available. We offer evidence-based therapies and personalized treatment plans.

What Is Drug Addiction (Substance Use Disorder)?

Substance use disorder (SUD)—often called addiction—is a chronic, treatable medical condition in which alcohol, medications, nicotine, cannabis, opioids, or other drugs are used in a problematic pattern that harms health, safety, or daily life. The brain’s reward, stress, and self-control systems change over time, making it hard to cut back despite negative consequences. Some people develop SUD after recreational use; others after prescribed exposure (e.g., opioid pain medicines). Risk and speed of addiction vary by substance (opioids tend to carry higher, faster risk).

Not everyone who uses a substance becomes addicted. Genetics, mental health, environment, and age of first use all influence risk.

Common Signs and Symptoms

People with SUD may have two or more of the following within 12 months (severity: mild 2–3, moderate 4–5, severe ≥6):
Using more or longer than intended; unsuccessful efforts to cut down
Strong cravings; spending a lot of time getting/using/recovering
Ongoing use despite relationship or health problems
Problems at work, school, or home; giving up activities
Tolerance (needing more for the same effect)
Withdrawal (symptoms when cutting down/stop)
Intoxication and Withdrawal
Intoxication: short-term effects while the substance is in your system (e.g., euphoria, sedation, impaired judgment).
Withdrawal: symptoms as levels fall (e.g., anxiety, insomnia, sweating, nausea, muscle cramps, mood changes). Some withdrawals (alcohol, benzodiazepines) can be dangerous and require medical supervision.

Other Conditions

Our holistic approach addresses the mind, body, and spirit - supporting your journey to healing and long-term recovery.

We integrate Functional Psychiatry into practice alongside traditional methods

Recognizing Unhealthy Use in a Loved One

Red flags can include: sudden friend changes; secrecy or isolation; declining performance at work/school; missed appointments; mood swings; disorganized sleep or eating; neglect of hygiene; unexplained money issues or missing items.

Why SUD Develops (Risk Factors)

Biology & genetics (family history, inherited vulnerability)
Mental health conditions (depression, anxiety, PTSD, ADHD)
Stress/trauma or adverse childhood experiences
Early initiation (use beginning in childhood/adolescence)
Social environment (peer use, availability/access)

Prevention & Harm Reduction

Follow prescription directions; never share medications; secure storage; use take-back programs for leftovers (especially opioids).
Build coping skills for life transitions and stress.
For opioid risks, know overdose signs (slow/absent breathing, unresponsiveness) and consider naloxone access where appropriate; call emergency services for suspected overdose.

15+

Years of experience

Complications

Overdose (medical emergency; opioids can stop breathing)
Infections (hepatitis B/C, HIV), cardiovascular, liver, kidney, and lung disease
Cognitive and mood problems; injuries; legal/occupational issues; relationship strain
Pregnancy risks to parent and fetus
Polysubstance use is common and increases risk

Diagnosis of SUD

A clinician reviews medical and mental health history, substance use patterns, prescription monitoring data when appropriate, physical exam, and lab/drug testing as indicated. Diagnosis is based on DSM-5 criteria (the 11 symptoms above) and degree of functional impact. Co-occurring conditions are routinely assessed.

Treatment (Evidence-Based and Individualized)

Best outcomes come from combining medications (when indicated) with behavioral therapies, matched to the person’s needs and level of care (outpatient, intensive outpatient/partial hospital, residential, or inpatient).

Withdrawal Management (“Detox”)

Medically supervised stabilization to relieve withdrawal and begin treatment planning. For alcohol and benzodiazepines, supervised care may be life-saving. Detox is a first step—not a stand-alone cure.

Medications for SUD

Opioid use disorder: methadone, buprenorphine, naltrexone
Alcohol use disorder: naltrexone, acamprosate, disulfiram
Tobacco use disorder: nicotine replacement (patch/spray/gum/lozenge), bupropion, varenicline
These reduce cravings, normalize brain signaling, and lower relapse/overdose risk. (There are no FDA-approved medications for stimulant or cannabis use disorders; targeted symptom management and behavioral therapies are used.)

Therapies and Supports

Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI/MET)
Contingency Management (CM) (structured incentives)
Dialectical Behavior Therapy (DBT) for emotion regulation
Family therapy and assertive community treatment (ACT) where appropriate
Mutual-help/peer support (e.g., NA, SMART Recovery) as adjuncts
Integrated care for dual diagnosis (mental health + SUD) is essential

Ongoing Care

Relapse can be part of recovery; it signals the need to adjust the plan, not to stop treatment. Regular follow-up, medication adherence, therapy, recovery supports, and attention to sleep, exercise, nutrition, and stress all improve outcomes.

When to Seek Help

Talk with a healthcare professional if you’re using regularly, struggling to cut down, or noticing the signs above. Seek emergency care for suspected overdose or severe withdrawal.

Vivabest Psychiatry PLLC: Our Approach

Comprehensive evaluation (medical, psychiatric, and substance history; labs/ECG when indicated; overdose risk; pregnancy considerations)
Medication-assisted treatment for opioid/alcohol/tobacco use disorders with careful monitoring
Integrated therapy (CBT/MI/CM/DBT) and dual-diagnosis care
Coordinated levels of care (outpatient, IOP/PHP, residential/inpatient) and linkage to community supports
Relapse-prevention planning with ongoing, measurement-based follow-up