Location definitely impacts the types and levels of substance abuse in Texas. Border communities uniformly note higher rates for cocaine, heroin, and other substances smuggled across the Mexican border. This includes students surveyed in Texas schools, which show striking differences between border communities and schools located farther away. Overall, Texas ranks among the lowest among all states for marijuana use, but among the highest in the country for cocaine use in the 12-17 age group.

Drug and alcohol treatment centers in Texas report shifts in the pattern of admissions for substance abuse treatment over the past 15 years. While alcohol and cocaine admissions are dropping, admissions to Texas rehabilitation centers for methamphetamine are increasing, particularly in north Texas. And as with every other state in the Union, abuse of prescription drugs in Texas is exploding, as shown in the chart below. Per the U.S. Drug Enforcement Agency, in some areas in Texas, abuse of oxycodone products like Oxycontin have now surpassed the extremely high rate of abuse of hydrocodone. Regardless of type, admissions to Texas drug and alcohol treatment centers have doubled since 1992, from 22% to over 52% in 2005.

In 2006, there were 523 drug and alcohol drug and rehabilitation centers in Texas. Nearly half were private nonprofit facilities; 224 were private for-profit treatment centers, and the rest were operated by various local, state, or federal agencies. Residents of Texas therefore have a wide choice of facilities, but should carefully evaluate all local options to ensure that programs encompass the full range of services needed to combat a particular addiction. Most treatment facilities in Texas provide outpatient treatment. Residential care is offered by 162 of the 523 rehab centers.

Because treatment for opiate addiction usually involves using other controlled drugs during the detoxification and management stages of recovery, rehabilitation centers in Texas must be certified for certain types of programs. Only 70 Texas rehab centers offer opioid programs; families seeking help for an addiction to Oxycontin, Xanax, or any of the many other prescription sleep aids and painkillers abused in Texas may have to look outside their local area for the proper treatment program.

One especially troubling trend in substance abuse in Texas is noted in the two charts below. Over 13% of Texas students have tried inhalants, and the practice is most prevalent among younger students. In her report for the Center for Excellence in Drug Epidemiology, Dr. Jane Maxwell speculates that the lower incidence among older students may come from the fact that inhalant users drop out of school and are not available to the survey as they grow older. It is a compelling argument for early treatment for any suspected drug abuse, but especially for young people. Surveys of Maryland substance abusers indicate that a high percentage of long-time users were first exposed to drugs and alcohol as adolescents.

Modern children are at constant risk of involvement with drugs and alcohol from an early age. But for adults, too, the specter of “rehab” looms over parties, clubs, gyms, even the home medicine cabinet, where a perfectly legal prescription can lead to an addiction nightmare. Drug and alcohol rehabilitation centers in Texas treated just under 44,000 people in 2006. Eleven percent were children. No one in Texas should ever believe it could not happen in their family.