A. Statewide Overview of Substance Use

Substance use by parents in DFPS cases is very common. Current trends show that methamphetamine continues to be the primary drug threat and continues to increase in Texas, a pattern consistent with that seen in other states. Cocaine indicators continue to decrease but heroin indicators have been increasing as well as increases in fentanyl use, specifically used to “cut” heroin.[219] The Texas Prescription Monitoring Program (PMP) and overdose prevention programs have led to decreases in the number of opiate, synthetic narcotic, and benzodiazepine drugs prescribed.[220]

Death rates associated with heroin have increased steadily since 1999 with the highest number of deaths occurring in the 24-34 age group. There has been a decrease in heroin-related poison center calls, yet a rising number of toxicology reports, deaths, and seizures are being identified; however, Texas has not suffered the epidemic of overdoses seen in the northeast United States.[221]

1. Useful Definitions from the Health and Human Services Commission (HHSC)

•   Substance Use: use of a substance.

•   Substance Misuse: using a substance in a way that is not consistent with medical or legal guidelines (e.g., using two pills rather than one as prescribed to assist with sleep).

•   Risky Use: refers to using a substance in ways that threaten the health and safety of the user or others (e.g., drunk driving).

•   Substance Use Disorder (SUD): a condition marked by a cluster of cognitive, behavioral, and physiological symptoms in which the use of a substance leads to clinically significant impairment or distress in a person's life. Substance use disorders range can range widely in severity (Mild, Moderate, or Severe), with severe substance use disorders typically including clinical criteria of tolerance and withdrawal.

•   Recovery: A process of change through which an individual improves their health and wellness, lives a self-directed life, and strives to reach the individual's full potential. Recovery is a personal journey of increased hope and personal identity that may include the elimination of substance use.[222]