Texas Child Protection Law Bench Book

2024 version: As effective October 1, 2024

A. Statewide Overview of Substance Use

Substance use by parents in DFPS cases is very common. According to the National Center on Substance Abuse and Child Welfare parental substance use was a condition associated with removal in 76.7% of children under the age one and 62.6% of children over the age of one in Texas.[145]

Special Issue: The term “abuse” is highly associated with negative judgments and punishments. The preferred terms are substance “use” when referencing illicit drugs and “misuse” for prescription medications used other than prescribed. [146]

1. Relevant Trends

Methamphetamine continues to be perceived as the primary drug threat by the three Drug Enforcement Agency (DEA) Field Divisions covering Texas. Cocaine indicators continue to decrease. However, heroin and fentanyl indicators have been increasing, including the adulteration of the heroin supply, the use of fentanyl alone or in combination with other substances such as methamphetamine, and pressed pills disguised to look like prescription opioids and sedatives. About half (51.6%) of drug-related deaths in 2022 had at least two substances indicated and over half (68.5%) of drug deaths involving more than one substance included fentanyl.[147]

For information about drug-related deaths and trends in Texas, please visit the Department of State Health Services Texas Health Data Dashboard.[148]

2. Useful Definitions:

•   Substance Use: The use—even one time—of any substance.[149]

•   Substance Misuse: The use of any substance in a manner, situation, amount, or frequency that can cause harm to users or to those around them. For some substances or individuals, any use would constitute as misuse (e.g., under-age drinking, injection drug use).[150]

•   Substance Use Disorder (SUD): A medical illness caused by repeated misuse of a substance or substances. According to the DSM-5, substance use disorders are characterized by clinically significant impairments in health, social function, and impaired control over substance use and are diagnosed through assessing cognitive, behavioral, and psychological symptoms.[151]

•   Recovery: a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. The process of recovery is highly personal and occurs via many pathways. It may include clinical treatment, medications, faith-based approaches, peer support, family support, self-care, and other approaches. Recovery is characterized by continual growth and improvement in one's health and wellness and managing setbacks. Because setbacks are a natural part of substance use, resilience becomes a key component of recovery.[152]

Every health region in Texas has an Outreach, Screening, Assessment and Referral (OSAR) Program which can assist any Texas resident with finding appropriate treatment and community resources. To find local resources and additional assistance, please visit the HHSC OSAR webpage.[153] Individuals can also locate substance use services in their area by visiting the Health and Human Services - Substance Use Service Locations map.[154]