Substance Use Disorder

Common substance use disorders we treat are nicotine/tobacco, alcohol and marijuana. But we treat many others like:

• Amphetamines.
• Cocaine.
• Hallucinogens like PCP and LSD.
• Inhalants.
• Opioids.
• Other medications like sleeping pills, benzodiazepines and barbiturates.

These different substances have one thing in common — the way they affect your brain. When you use any of these, they trigger your brain’s “reward center” and a “feel-good” hormone called dopamine. Sometimes way too much. And your brain chemistry can change when you keep using these things. This creates both physical and psychological dependence.

Having a substance use disorder isn’t a sign of weakness or lack of willpower. It’s a chronic health condition. And you may feel like it’s impossible to quit on your own. That’s why there’s substance use disorder evaluation and treatment.

What to expect during your evaluation

Your story is important to us. So, when you come for your first visit, you’ll spend time talking with your provider about what’s been going on. They’ll want to know:

• What substances are you using?
• How long have you been using these substances?
• How much of these substances do you use each day?
• How is using these substances affecting your daily life and relationships?
• Have you been diagnosed with any mental health conditions?
• Do you feel anxious or depressed?
• Do you have any chronic health conditions?

Your provider may do a physical exam and order blood tests and a urinalysis. Our team uses the information from this visit to decide how severe your substance use disorder is. And to build a treatment plan based on your unique needs.

Meet Our Substance Use Disorder Team

Your care team knows treatment is a big step. And that it might feel hard to want to keep doing it at times. We work together to make sure you get expert care combined with compassionate support so you can keep moving forward. Your care team may have providers from different specialties, like:

• Primary care providers.
• Psychiatrists trained in addiction psychiatry.
• Psychologists.
• Addiction counselors.
• Advanced practice providers.
• Social workers.

Substance use disorder treatment is highly personalized. It depends on what substance or substances you’re using. We also look at how severe the disorder is and your overall health. You may need different types of treatments at different times, including ongoing care and counseling. You may have treatment at a medical office and go home after your appointment. Or we may have you stay in the hospital for a bit.

When you start treatment, we’ll help you understand that substance use disorders are chronic conditions. We’ll talk about how to recognize the triggers that make you want to use your substance of choice. And we’ll talk about consequences and even potentially life-threatening situations that can happen if you have a substance use disorder.

During your treatment program, you may have:

Detoxification

Detoxification is usually the first step of any substance use disorder treatment. Depending on your condition, you may go through withdrawal (detoxification) in the hospital or at home under care of a provider. If done in the hospital, you’d be admitted to a floor that has experienced clinicians in addiction psychiatry who’d monitor you both physically and emotionally. You’ll also have access to medical consultants to make sure we look at the full picture of health. We keep a close eye on you as you stop taking the substance(s). We frequently use medication to help with withdrawal effects and to make the process of coming off substances as comfortable as possible.

Cognitive and behavioral therapies

Emotions and behavior play a big role in substance use disorders. You may have started using substances because of anxiety, stress or depression. And maybe you kept using them because they made you feel good. We often build counseling and therapy into treatment plans, like two kinds of psychotherapy (talk therapy):

• Cognitive behavioral therapy (CBT).
• Dialectical behavior therapy (DBT).

We may also recommend that you get involved in group therapy or a 12-step program during and after treatment.

Medication

Some medications can help change your brain chemistry and treat certain substance use disorders. They can also help reduce cravings and withdrawal symptoms. Your providers will go over what, if any, of these might be right for you, and if you can take them during your hospital stay and/or continue to take them at home.

Intensive outpatient programs (IOPs)

IOPs can provide an intermediate level of care between the regular outpatient care and inpatient care. They may include additional psychiatry specialists and counselors, who provide a comprehensive approach to substance use disorder treatment. Typically, once a patient is detoxed, they may want to enroll in an intensive outpatient program (IOP) which is run over four to five weeks, three hours a day, four days a week. The patient can participate in the IOP program either in person or virtually.

Family support

Substance use disorders can also affect families. Your spouse, children, significant other and extended family members may benefit from programs that help them understand the nature of these disorders and how the family dynamic plays a role in recovery. This includes counseling, support groups and 12-step programs like Al-Anon and Ala-Teen.

Life After Substance Use Disorder Treatment

Recovery doesn’t end when treatment stops. It’s a road you’ll always travel going forward. You’ll have ups and downs along the way. We make sure you have the tools and support network to help you navigate the twists and turns. You may also benefit from residential programs or sober housing, options our experienced teams will advise you about. Even on days when you feel alone, know that you aren’t. You can talk with family and friends, make a counseling appointment, visit a support group or go to a 12-step meeting.

Taking the Next Step

Substance use disorders affect people from all walks of life. And when you have one, it can be hard to admit it. Or stop it on your own. Cleveland Clinic is here for you. We have the programs in place to treat this chronic medical condition. From regular counseling or more intensive treatment, we want to help you get back to living your best life.