Danielle Williams, MS, LAC, LPC

In 2023, 48.5 million Americans over the age of 12 (or 16.7%) suffered from a substance use disorder in the past year. Substances include tobacco, alcohol, vaping, marijuana, and other illegal drugs such as stimulants or opioids.

Substance use disorder or substance abuse can affect anyone, but risk factors include having a family history of substance use, an underlying mental health condition, a chaotic home environment with abuse, neglect, or violence, peer pressure, and other psychological factors.

While each case is different and ranges in severity, substance use disorder usually starts with experimentation, moves to occasional use during social situations or for medical treatment, and escalates to heavy use daily or several times a day.

Signs of substance use disorder include having a strong desire or urge to use the substance, having difficulty managing or using less, spending more time obtaining, using, and recovering from the substance, having more difficulty managing a job, school, or relationships, using substances even when it’s dangerous, and having withdrawal symptoms that are relieved by taking more of the substance. Prescription drugs can also lead to substance use disorder for some people.

Many with substance use disorder have a false sense of invincibility and confidence that they can handle the drugs or other substances they take. However, over time, they may become frustrated by not being able to get high anymore, using drugs only to avoid getting sick, or having more episodes of overdosing. Substance use disorder can also lead to serious life problems related to addiction, such as the loss of a job or home, and strained relationships with one’s children or spouse.

Thankfully, the consequences of addiction can often lead to motivation to get help. Substance use disorder treatment is the most effective road to recovery for someone dealing with drug or alcohol addiction.

Substance use disorder treatment may include inpatient, medical detox, outpatient, or a combination, depending on the patient’s needs. Medication assisted treatment options are available to help treat people with an alcohol or opioid use disorder.

Medication assisted treatment (MAT) is used to normalize brain chemistry and body functions, block euphoric effects, and decrease cravings. These evidence-based drugs can also prevent or treat an overdose and help promote long-term recovery. At HopeHealth, our substance use disorder treatment program includes medications like Narcan, Vivitrol, Sublocade, or Suboxone, and the use of these medications depends on the individual’s diagnosis.

Counseling and behavioral therapy are also vital for a holistic approach in substance use disorder treatment. The two primary treatment models include the abstinence-based model and the harm reduction model.

The traditional abstinence-based model familiar to many people is Narcotics Anonymous or Alcoholics Anonymous, a 12-step program aimed at abstinence. This zero-tolerance approach is also used in many inpatient and outpatient facilities with random drug screens, group treatment, and care coordination to help people maintain sobriety. This approach is helpful for many people, but it often keeps others from seeking treatment.

While abstinence is the ultimate treatment goal, often people may not be ready to totally quit. The harm reduction model is an option for these patients. Harm reduction focuses on decreasing the harmful consequences as opposed to the abstinence “cold turkey” approach of eliminating drug use. This approach is designed to meet people where they are, with the philosophy that there is no “one size fits all” treatment.

The harm reduction approach does not ignore the harm and danger of drug use. Instead, it empowers the person to take charge. Therapists share information and education, and offer support and strategies to empower people who use drugs to take responsibility and make changes to reduce the harm to themselves. This can include a continuum of behaviors to be safer with drug use and working toward a decrease or abstinence over time. Examples of harm reduction include taking a smaller dose of a drug, using clean needles for IV drug users, not using alone, and agreeing to call the Never Use Alone – Overdose Prevention Hotline at

(800) 484-3731 if they feel at risk of overdosing.

Treatment philosophies are a sensitive topic, and the harm reduction approach is not always popular. However, I truly believe that meeting patients where they are and building from there is a vital step in addressing the overdose crisis in the U.S. Since relapse is common, people may come back to therapy at any time and are not typically discharged. One particular client used the harm reduction approach and, over time, completely stopped using drugs. He disappears from therapy when doing well, and will call if he starts feeling the urge to use. Knowing he has the support to return to treatment at any time has kept him clean for many years.

At HopeHealth, substance use disorder treatment is available at the HopeHealth Medical Plaza in Florence, HopeHealth in Manning, and HopeHealth in Orangeburg. Patients start with a diagnostic assessment to determine an appropriate treatment plan. As an outpatient treatment facility, our treatment plans use MAT for a diagnosis of opioid use disorder or alcohol use disorder and forgo MAT for all other substance use disorders. Some may be referred to an inpatient treatment facility if medically warranted. We work with each patient’s unique and special needs to provide an appropriate level of care that is regularly updated as patients progress through treatment.

Substance use disorder takes time to overcome, but there is always hope to become free from addiction and create a new life that makes it easier not to use. If you are suffering from substance use disorder, take the first step toward healing and reach out for help.

Danielle Williams is a behavioral health counselor specializing in alcohol and substance use disorder treatment at HopeHealth. She is accepting new patients. You do not have to be a patient at HopeHealth for substance use disorder treatment. A brief and confidential phone assessment is required before scheduling an appointment. Call (843) 432-3690 for more information about substance use disorder and treatment.