According to the Centers for Disease Control and Prevention (CDC), substance use refers to the use of alcohol, tobacco products, drugs, inhalants or other substances that can be consumed, inhaled, injected or otherwise absorbed into the body with possible dependence and other harmful effects.

In 2017, the U.S. Department of Health and Human Services declared the opioid epidemic a national public health emergency.

Although alcohol and substance use disorders can harm a person’s health, relationships and ability to work, they are treatable and can be managed with the right care, such as medication and therapy. 

There are many resources in the community that offer help, support and treatment for those who need it.

Causes & Risk Factors for Alcohol & Substance Use

Substance use can affect anyone. However, the following factors increase the likelihood of substance use:

• Childhood neglect or maltreatment  
• Family history of substance use 
• Family or personal history of mental illness
• First use of alcohol or drugs at a young age 
• Laws and social norms favorable to substance use 
• Neighborhood poverty and violence 
• Psychological trauma at any age

Alcohol & Substance Use Prevention

Prevention is the best way to combat substance use, which becomes less likely in the presence of these protective factors: 

• Financial stability
• Healthy family and peer relationships
• Parental monitoring of youths and parental disapproval of substance use 
• Policies limiting the availability of alcohol 

Overdose Prevention

According to the CDC, more than 80% of drug overdose deaths involved opioids. 

According to the National Institute on Drug Abuse, bystanders were present at 1 in 3 opioid overdoses. When a bystander has naloxone on hand and knows how to use it, they can save the life of someone who has overdosed. Naloxone (brand name Narcan) is a life-saving medication that reverses opioid overdoses, including heroin and fentanyl. 

Have naloxone available if you or someone in your household has a substance use disorder or has been prescribed opioids. Get free naloxone mailed to your home.

Substance Use in Bexar County

About 6% of Bexar County adults had a substance use disorder in 2019, according to the January 2022 report [PDF] of Bexar County’s Task Force on Criminal Justice and Behavioral Health. 

The drug overdose mortality rate in Bexar County is about 18 per 100,000 people. That’s slightly higher than the mortality rate in Texas (16), but lower than the national overall mortality rate (33). 

A total of 1,146 county residents died of drug overdoses from 2016 to 2020, according to research organization NORC at the University of Chicago.  

Texas Opioid Statistics

Texas Public Health Region 8, which includes San Antonio, saw 721 opioid-related visits to the emergency department in 2021. Opioid-related visits accounted for 54 of every 100,000 emergency visits that year.

The rate of opioid prescriptions per 1,000 adults in Bexar County fell from 546 in 2016 to 441 in 2020, according to CDC data. That’s a decrease of 19%. 

University Health Resources 

STOP (South Texas Overdose Prevention)

STOP expands and enhances overdose prevention and harm reduction services for minority individuals who have, or at risk of developing, substance use disorders.

Order free harm reduction supplies. For more information, please download our brochure. 

OTRS (Overdose Treatment and Recovery Services)

OTRS aims to reduce overall opioid use disorder (OUD) in South Texas. To enroll in OTRS, please fill out the self-referral or referral by provider forms. For more information, please download our brochure. 

New Start

New Start provides aid and support to men and women in substance use recovery.

Services provided at no cost:

• 90 days of counseling treatment
• HIV/VH (B+C) testing and education
• Case management
• Recovery support services
• Health education

Who may participate:

• Be 18 years of age or older
• Resident in Bexar County
• Have a history of drug or alcohol use in the last 12 months

To enroll in New Start, please fill out the referral form. For more information, please download the brochure. 

Integrated Family Planning Opioid Response Project (IFPOR)

The Opioid Program is a partnership of providers and clinics within University Health’s Family Planning Program which provides Medication-Assisted Treatment and counseling to help patients with Opioid Use Disorder.

With guidelines established by the Family Planning Program, our staff will help guide you through eligibility, screening and referral for treatment.

SMASH (Substance Misuse Awareness & Sexual Health)

SMASH aims to prevent substance misuse, transmission of HIV and hepatitis among men aged 18 and above living in Bexar County who are at risk for substance abuse and HIV/AIDS.

What SMASH offers:

• A judgment-free, safe environment to discuss your health needs and questions
• Free prevention services for substance abuse, HIV/AIDS and hepatitis, specifically:
  
  • Condom distribution
  • HIV/hepatitis testing
  • Peer support
  • PrEP (HIV prevention pill)
  • Screening for substance abuse risk
  • Referrals to treatment and other support services (e.g. housing, employment, etc.)

For more information, download our brochure or visit smashsa.com. 

The Mommies Program

The Mommies Program at University Health helps mothers receiving methadone or buprenorphine for opiate use disorder as well as those with any substance use disorder. This includes methamphetamines, cocaine, benzodiazepines and other substances.

The program helps pregnant women with substance use disorder get critical prenatal care and have the healthiest possible pregnancy and baby. 

Patient navigators connect patients with clinics that provide medication treatment, such as methadone or buprenorphine, for those with opiate use disorder. Treatment is provided at outside clinics such as the Center for Health Care Services.

Community Resources

San Antonio Community Resource Directory

Find resources in your area using the SACRD online search tool. Search for addiction and recovery, mental health, harm reduction services and more.

Be Well Texas

Be Well Texas expands access to compassionate, evidence-based treatment for people who use substances or who have substance use disorders (alcohol or drug) and/or mental illness.

There are Be Well Texas outpatient services at UT Health San Antonio.

The Center for Health Care Services 

The Center for Health Care Services provides integrated care to improve the lives of children and adults with mental health conditions, substance use challenges and intellectual or developmental disabilities in Bexar County. 

Search the Center’s program directory for information about substance use interventions. 

Mobile Integrated Healthcare 

Mobile Integrated Healthcare extends the San Antonio Fire Department’s reach into the community. One aspect is community education, Narcan kits, and harm reduction education. The second allows MIH to give buprenorphine to patients in their homes to help them start recovery from opioid use disorders.

San Antonio Council on Alcohol & Drug Awareness (SACADA)

SACADA empowers our community to live healthy lives by providing prevention, intervention, and recovery support services for children and adults.