Substance Use treatment in Texas
Telehealth psychiatric care for adults — based in Austin, serving patients statewide.
Substance use rarely shows up alone. Most adults who struggle with alcohol, cannabis, stimulants, opioids, sedatives, or other substances are also navigating depression, anxiety, trauma, ADHD, bipolar disorder, or chronic pain — and treating one without the other is a setup for relapse. Co-occurring or dual-diagnosis care addresses both layers together: the psychiatric condition that may be driving the use, and the substance use itself.
This practice provides non-judgmental psychiatric care for adults with substance use concerns. We are realistic about what telehealth medication management can and cannot do — meaningful long-term substance-use recovery usually involves dedicated addiction-medicine specialists, peer recovery communities (AA, NA, SMART Recovery), and sometimes intensive outpatient or residential programs. We work alongside those resources rather than trying to replace them.
What this practice offers and does not offer: I provide psychiatric medication management for the mental-health conditions that co-occur with substance use, plus naltrexone for alcohol or opioid use disorder when appropriate. I do not currently prescribe buprenorphine (Suboxone) or methadone — those are referred to dedicated MAT/OUD specialists in Austin. I also do not provide detoxification services; medical detox happens in supervised settings.
Signs you may benefit from treatment
- Using more than you intended, or for longer than you intended
- Wanting to cut down or stop, but unable to
- Spending significant time obtaining, using, or recovering from substance use
- Cravings or strong urges to use
- Use that interferes with work, school, family, or relationships
- Continued use despite social or interpersonal problems caused by it
- Giving up activities you used to enjoy
- Use in physically dangerous situations (driving, operating machinery)
- Continued use despite knowing it's harming your physical or mental health
- Tolerance — needing more to get the same effect
- Withdrawal symptoms when not using
- Substance use that started or worsened during a depressive, anxious, or traumatic period
How Eki Mental Health PLLC treats substance use
We meet you where you are. You don't need to be in active recovery to start psychiatric care here — many patients begin while still using and use the stabilization of effective psychiatric treatment as part of how they get to a different relationship with substances. We don't use shame as a tool.
The first visit is an honest assessment of what you're using, how often, what it's doing for you, what it's costing you, and what other psychiatric conditions are in the picture. From there, treatment combines medication management for the psychiatric layer (depression, anxiety, trauma, bipolar disorder, ADHD), targeted medications for substance-use disorders when indicated (naltrexone, acamprosate), and coordinated referrals to Austin's addiction- medicine specialists, peer recovery groups, IOP/PHP programs, and harm-reduction resources.
Treatment options
1. Treating the psychiatric condition driving the use
For most patients, substance use is partly self-medication for an underlying psychiatric condition that wasn't treated effectively. SSRIs/SNRIs for depression and anxiety, mood stabilizers for bipolar disorder, non-stimulant ADHD medications, and prazosin or other trauma-informed treatments for PTSD all reduce the pull toward substances when they're working well. This is the foundation of dual- diagnosis care.
2. Medication-Assisted Treatment (MAT) — what we offer and refer
- Naltrexone (oral or Vivitrol injection) — for alcohol use disorder and opioid use disorder (after detox). Non-controlled, no abuse potential. Strong evidence for reducing heavy drinking and craving. We prescribe and manage this.
- Acamprosate (Campral) — for alcohol use disorder, particularly after the initial abstinence period. Non-controlled. We prescribe and manage this.
- Disulfiram (Antabuse) — for alcohol use disorder; produces unpleasant reaction if alcohol is consumed. Used selectively. We can prescribe.
- Buprenorphine (Suboxone, Sublocade) and methadone — for opioid use disorder. Referred to dedicated MAT specialists in Austin (CommUnityCare, Texas Recovery Initiative, and others). We do not currently prescribe these.
3. Coordination with addiction specialists and recovery resources
Sustained recovery usually requires more than medication. We coordinate referrals to the resources that work:
- Austin addiction-medicine practitioners for buprenorphine, methadone, or specialty addiction care
- Intensive outpatient programs (IOP) and partial-hospitalization programs (PHP) when daily structure is needed
- Peer recovery communities — AA, NA, SMART Recovery, Refuge Recovery, In the Rooms (online); we'll talk about what fits your worldview
- Harm-reduction resources — naloxone (Narcan) for anyone using or around opioids, fentanyl test strips, syringe-services programs
- Therapy — CBT, motivational interviewing, contingency management, and trauma-focused therapy with therapists who work with substance use
4. Harm reduction is care
Some patients are not ready for abstinence — and that does not mean they can't benefit from psychiatric care. We work from a harm-reduction stance: less is better than more, safer is better than unsafer, and engagement is better than no engagement. Naloxone in your home, fentanyl test strips, never using alone, and never combining opioids with benzodiazepines or alcohol are all harm-reduction interventions that save lives.
5. About benzodiazepines and other controlled medications
Benzodiazepines (Xanax, Klonopin, Ativan, Valium) carry significant risk for patients with current or past substance use, particularly in combination with alcohol or opioids. For patients with substance use concerns, we generally avoid benzodiazepines and rely on non-controlled options for anxiety. The full prescribing approach is in our controlled-substance policy.
What to expect at your first visit
Your first visit is a comprehensive 60–90-minute evaluation. We will talk honestly about what you're using, how often, what it's doing for you, and what other psychiatric concerns are in the picture. You do not need to be sober to start, and you will not be judged or shamed. The goal is to build a treatment plan that addresses the whole picture — not just the substance use, and not just the underlying psychiatric layer.
If you are in active withdrawal, struggling with overdose risk, or in psychiatric crisis, please call 988 or 911, or call the Austin Travis County Integral Care 24/7 Crisis Line: 512-472-4357. Telehealth is not the right level of care for acute withdrawal or overdose risk — those need supervised settings.
Optional: GeneSight pharmacogenomic testing
If you'd like, we can order GeneSight at your first visit — a simple cheek-swab genetic test that analyzes how your body metabolizes psychiatric medications and provides a clinician-facing report to guide prescribing.
Benefits:
- Reduces medication trial-and-error by predicting which medications you're likely to tolerate well
- Identifies medications you may metabolize too quickly (less effective) or too slowly (more side effects)
- Especially useful if you've had a hard time tolerating medications in the past or first-line options haven't worked
- Covers 60+ psychiatric medications — antidepressants, antipsychotics, mood stabilizers, anxiolytics, ADHD meds
- One-time test — your genes don't change, so results stay relevant for life and follow you to future prescribers
- Non-invasive cheek swab; results typically return within 2–3 days
Entirely optional — we only order it if you want it. Insurance coverage varies; we'll review cost and coverage with you before ordering.
Insurance & cost
In-network with Aetna and UnitedHealthcare / Optum; most insured patients pay $20–$60 per visit after benefits. Self-pay rates: $400 initial evaluation, $250 standard follow-up. Superbill provided for out-of-network reimbursement. Full pricing & insurance details →