Substance use and addiction treatment in Miami Florida
Santana Mental Health Services provides comprehensive substance use evaluations and individualized treatment plans for adolescents and adults. Addiction is a medical condition, not a moral failing, and effective treatment exists. Our providers use evidence-based psychotherapy and medication management to help patients reduce or stop substance use, address co-occurring mental health conditions, and build a sustainable path toward recovery. Care is available both in-office and through secure telehealth services.
Understanding Substance Use Disorders
A substance use disorder (SUD) is a medical condition in which a person continues to use a substance despite significant harm to their health, relationships, or daily functioning. SUDs involve real changes in brain circuits that affect motivation, decision-making, impulse control, and stress response — which is why willpower alone is rarely enough to overcome them. Approximately 1 in 6 Americans meets criteria for a substance use disorder in a given year, yet fewer than 15% receive any treatment. SUDs can range from mild to severe and can develop with alcohol, opioids, stimulants, cannabis, sedatives, and other substances. They frequently co-occur with depression, anxiety, PTSD, and other mental health conditions — roughly 75% of people with a substance use disorder have at least one co-occurring mental health condition. The good news is that substance use disorders are treatable, and most people who receive evidence-based care see meaningful improvement.
Alcohol use disorder
Alcohol use disorder (AUD) is the most common substance use disorder. Approximately 10–11% of Americans meet criteria for AUD in a given year, and nearly 30% will experience it at some point in their lifetime. AUD can range from mild to severe and involves difficulty controlling alcohol use, continuing to drink despite negative consequences, and in many cases, tolerance and withdrawal. Alcohol contributes to more than 140,000 deaths annually in the United States and is associated with liver disease, cardiovascular disease, cancer, and mental health conditions including depression and anxiety.
Opioid use disorder
Opioid use disorder (OUD) involves a problematic pattern of opioid use, including prescription painkillers, heroin, or illicit fentanyl, that leads to significant impairment or distress. OUD is one of the most serious public health challenges in the United States, with opioid-involved overdoses accounting for the majority of the more than 100,000 annual drug overdose deaths. Effective medications exist that reduce the risk of overdose death by 50–60%, yet OUD remains significantly undertreated. Treatment can be life-saving.
Sedative, Hypnotic, and Benzodiazepine use disorder
Sedative use disorder involves problematic use of medications such as benzodiazepines (e.g., alprazolam, clonazepam, diazepam), sleep medications, or barbiturates. These substances can produce physical dependence relatively quickly, and withdrawal can be medically dangerous — in some cases life-threatening. Treatment often requires a carefully supervised medical taper alongside behavioral support.
Stimulant use disorder
Stimulant use disorder involves problematic use of substances such as cocaine, methamphetamine, or prescription stimulants (such as amphetamines). Stimulant use can lead to cardiovascular complications, psychosis, severe mood disturbances, and significant functional impairment. There are currently no FDA-approved medications for stimulant use disorder, making psychotherapy — particularly contingency management and cognitive behavioral therapy — the primary evidence-based treatment approach.
Substance use and co-occurring mental health conditions
The majority of people with a substance use disorder also have a co-occurring mental health condition. Depression and anxiety are the most common, but PTSD, bipolar disorder, ADHD, and personality disorders are also frequently present. In many cases, substance use begins as an attempt to cope with untreated emotional pain, trauma, or distress. Effective treatment addresses both the substance use and the underlying mental health condition together.
Cannabis use disorder
Cannabis use disorder has become increasingly common, particularly as cannabis has become more widely available and more potent. It involves difficulty controlling cannabis use despite negative effects on motivation, memory, mood, or daily functioning. While often perceived as less harmful than other substances, cannabis use disorder can significantly impair quality of life and is associated with increased risk of anxiety, depression, and psychotic symptoms, especially with high-potency products.
When to Seek an Evaluation
Substance use exists on a spectrum, and it is not always easy to recognize when use has crossed the line into a problem. Many people minimize or rationalize their use for months or years before seeking help. You do not need to hit "rock bottom" to benefit from treatment. In fact, earlier intervention is associated with better outcomes. Consider scheduling an evaluation if you notice:
• Using more of a substance, or using it more often, than you intended
• Wanting to cut down or stop but finding it difficult to do so
• Spending a significant amount of time obtaining, using, or recovering from a substance
• Experiencing cravings or strong urges to use
• Substance use interfering with responsibilities at work, school, or home
• Continuing to use despite relationship problems, health consequences, or legal issues
• Giving up activities you used to enjoy because of substance use
• Using in situations where it is physically dangerous (such as driving)
• Needing more of the substance to get the same effect (tolerance)
• Experiencing withdrawal symptoms when you stop or cut back (such as anxiety, tremors, sweating, nausea, or insomnia)
If any of these patterns feel familiar, an evaluation can help clarify where things stand and what options are available — without judgment and without pressure.
How Substance Use Disorders Are Treated
Effective treatment for substance use disorders combines psychotherapy, medication management (when appropriate), and ongoing support. Because addiction involves lasting changes in brain function, it is best understood and treated as a chronic condition, similar to diabetes or hypertension, where ongoing management leads to the best outcomes. Treatment is personalized based on the substance(s) involved, severity, co-occurring conditions, prior treatment history, and individual goals.
Medication for Substance Use Disorder
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Several FDA-approved medications can help people reduce or stop drinking:
• Naltrexone — available as a daily pill or monthly injection, naltrexone blocks the brain's opioid receptors and reduces cravings and the rewarding effects of alcohol. A systematic review found a number needed to treat of 11 to prevent return to heavy drinking. Naltrexone can be started even while a person is still drinking. It is contraindicated in people currently using opioids or with significant liver disease.
• Acamprosate — taken three times daily, acamprosate helps maintain abstinence by stabilizing brain chemistry disrupted by chronic alcohol use. It is particularly helpful after a person has already stopped drinking. The number needed to treat to prevent return to any drinking is 11. Acamprosate is a good option for people who cannot take naltrexone due to liver disease.
• Disulfiram — works by causing an unpleasant reaction (nausea, flushing, rapid heartbeat) if alcohol is consumed. It is most effective when taken under supervision and is best suited for highly motivated patients committed to abstinence.
• Topiramate and gabapentin — although not FDA-approved for alcohol use disorder, both have evidence supporting their use and may be prescribed off-label when first-line medications are not effective or appropriate.
Despite strong evidence, medications for alcohol use disorder remain significantly underprescribed — fewer than 10% of people with AUD receive any medication.
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Medications for opioid use disorder are the standard of care and can be life-saving. Three FDA-approved medications are available:
• Buprenorphine — a partial opioid agonist that reduces cravings and withdrawal symptoms while blocking the effects of other opioids. Buprenorphine reduces the risk of all-cause mortality by approximately 60%. It is available as a daily sublingual tablet or film, or as a weekly or monthly injection. Buprenorphine can be prescribed in office-based settings and through telehealth.
• Methadone — a long-acting full opioid agonist that reduces cravings, prevents withdrawal, and reduces the risk of all-cause mortality by approximately 50%. In the United States, methadone for opioid use disorder is dispensed through specially licensed opioid treatment programs.
• Naltrexone — an opioid antagonist that completely blocks the effects of opioids. Available as a daily pill or monthly injection. Naltrexone requires a period of opioid abstinence (7–10 days) before starting to avoid precipitated withdrawal. Once initiated, injectable naltrexone has shown similar reductions in opioid use compared with buprenorphine.
Medication for opioid use disorder is not "substituting one drug for another" — it is evidence-based medical treatment that saves lives, reduces overdose risk, improves social functioning, and supports long-term recovery.
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• Medications for substance use disorders are most effective when combined with therapy and behavioral support
• Side effects vary by medication and are generally manageable — common side effects include nausea, headache, and sleep changes
• Treatment duration is individualized; for many patients, longer treatment is associated with better outcomes
• Medication changes should always be made gradually and under provider guidance
• Your provider will work with you to find the right medication, dose, and treatment plan based on your specific situation and goals
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Because substance use disorders and mental health conditions so frequently co-occur, effective treatment addresses both at the same time. Treating depression, anxiety, PTSD, or other conditions alongside substance use — rather than requiring sobriety before addressing mental health — leads to better outcomes for both. Our providers are trained to evaluate and treat co-occurring conditions as part of a comprehensive, integrated treatment plan.
Therapy for Substance Use Disorder
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CBT is one of the most widely studied and effective psychotherapies for substance use disorders. It helps patients identify the thoughts, feelings, and situations that trigger substance use and develop practical coping skills to manage them. CBT has demonstrated effectiveness across multiple substance types, including alcohol, cannabis, cocaine, and amphetamines. Skills learned in CBT — such as recognizing high-risk situations, managing cravings, and problem-solving — continue to benefit patients long after treatment ends.
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Many people with substance use problems feel ambivalent about change — part of them wants to stop, and part of them does not. Motivational interviewing is a collaborative, nonjudgmental approach that helps patients explore and resolve this ambivalence, strengthen their own motivation for change, and set goals that feel meaningful to them. Research supports MI as an effective approach for alcohol and cannabis use disorders, and it is often used in combination with other therapies.
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Contingency management provides tangible rewards — such as vouchers, prizes, or other incentives — for positive behaviors like abstinence confirmed by drug testing. It is one of the most effective treatments for stimulant use disorders (cocaine and methamphetamine), where no FDA-approved medications currently exist. Research shows that contingency management increases abstinence, improves treatment retention, and reduces substance use across multiple substance types.
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Twelve-step facilitation is a structured clinical approach that encourages participation in mutual support groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These programs provide peer support, accountability, and a framework for long-term recovery. Research supports that active participation in mutual support groups is associated with improved abstinence rates and long-term outcomes, particularly for alcohol use disorder.
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Substance use affects the entire family, and involving family members or partners in treatment can improve outcomes. Family-based approaches help repair relationships, improve communication, and create a home environment that supports recovery.
Important Notice
This page is for educational purposes only and should not be used to self-diagnose or self-treat any mental health condition. If you are experiencing symptoms or concerns, a professional evaluation can help clarify what you may be experiencing and what treatment options may be appropriate. Santana Mental Health Services is here to offer compassionate care, guidance, and support.
Telehealth for Substance Use Treatment
Substance use evaluations and follow-up appointments are available through secure telehealth. Research suggests that telehealth-delivered substance use treatment is generally comparable to in-person care in terms of treatment retention, substance use reduction, and patient satisfaction.
Telehealth can help overcome common barriers to addiction treatment, including stigma, transportation difficulties, work or family scheduling conflicts, and limited access to addiction specialists in certain areas. The American Society of Addiction Medicine supports the expansion of telehealth for addiction care, and federal policy changes have made it easier than ever to receive evidence-based treatment, including medication for opioid and alcohol use disorders, through secure video visits.
Take the next step toward recovery. Book a secure telehealth appointment today and get support from the comfort of home, on a schedule that works for you.
Frequently asked questions
Didn’t find what you were looking for?
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Yes. Substance use disorders are well-established medical conditions recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Addiction involves real changes in brain circuits that affect motivation, decision-making, impulse control, and stress response. It is not a character flaw or a lack of willpower. Like other chronic medical conditions, addiction is treatable — and most people who receive evidence-based care see meaningful improvement.
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No. This is one of the most harmful myths about addiction. Research consistently shows that earlier treatment is associated with better outcomes. You do not need to lose everything before seeking help — if substance use is causing problems in your life, health, relationships, or functioning, an evaluation can help you understand your options and take the next step.
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For some substance use disorders, yes. Psychotherapy alone — particularly CBT, motivational interviewing, and contingency management — can be effective, especially for stimulant and cannabis use disorders where no FDA-approved medications exist. However, for opioid use disorder, medication is the standard of care and is associated with significant reductions in overdose death. For alcohol use disorder, medication combined with therapy often produces the best results. Treatment decisions are always individualized based on the substance involved, severity, and patient preferences.
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For most people, no. Substance use disorders tend to follow a chronic, relapsing course without treatment. Brain changes associated with addiction can persist long after a person stops using, making relapse common — especially without ongoing support. Untreated substance use disorders are associated with worsening physical and mental health, relationship breakdown, job loss, legal problems, and increased risk of overdose and death. Treatment can change this trajectory.
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This varies depending on the substance, severity, and individual circumstances. Some people benefit from a focused course of therapy over several months, while others need longer-term support. For opioid use disorder, longer duration of medication treatment is consistently associated with better outcomes, and many patients benefit from ongoing medication. The key principle is that addiction is best managed as a chronic condition — like diabetes or hypertension — where ongoing care and monitoring lead to the best long-term results.
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No. Relapse is a common part of the recovery process, not a sign that treatment has failed. Relapse rates for substance use disorders (40–60%) are similar to those for other chronic medical conditions like diabetes, hypertension, and asthma. A relapse is an opportunity to adjust the treatment plan, identify what triggered the return to use, and strengthen coping strategies. The most important thing after a relapse is to re-engage with treatment as quickly as possible.
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Yes. Both initial evaluations and ongoing follow-up appointments are available through secure video telehealth. Research supports that telehealth-delivered substance use treatment is comparable to in-person care for treatment retention and substance use outcomes. Telehealth can also help overcome barriers such as stigma, transportation, and scheduling — making it easier to access and stay engaged in care.