Texas is a gigantic state both in size and population. It is second in geographic size to Alaska, and second to California in population size.

As in other states, health care in Texas has experienced its share of problems. Despite having a gross domestic product (GDP) comparable to entire countries such as Australia, Texas has been ranked as one of the worst health care systems in the United States. The federal Agency for Healthcare Research & Quality noted that the state ranked poorly in areas such as support for the disabled, preventive care, and acute and chronic delivery.

Lack of proper healthcare services could impact access to treatment for people with alcohol or substance use disorder problems. In 2007, the Dallas Morning News cited poverty, illegal immigration, and politics as sources of the state’s health care problems.

Despite being ranked as one of the worst states in terms of health care, Texas has made significant progress in terms of substance use disorder treatment. Progress in substance use disorder treatment has been attributed partially to criminal justice reform under governor Rick Perry. The adoption of Texas culture in addressing substance use disorder is also believed to be responsible for the state’s progress in this area.

Culture and Substance Use Disorder

Culture consists of patterns of behavior that define the way of life of members of a given society. Patterns of beliefs and behaviors that define a social group can relate to social problems. In other cases, these beliefs can be keys to help unlock obstacles to chronic problems.

Every culture has attitudes about alcohol and other substances. College cultures may encourage binge drinking and the use of illicit drugs, for example. They may be less likely to judge people who use substances. People within this environment may not know the dangers of substance use disorder and alcoholism.

Other cultures have held beliefs and patterns of behavior that discouraged substance use disorder. Among the Aztecs who lived in the country now known as Mexico, drinking alcohol was strictly forbidden for everyday use for members of that society. People were only permitted to consume alcohol during religious ceremonies. Anyone found breaking this rule risked facing the death penalty.

Culture can positively impact attitudes. It can serve as a deterrent for people who may otherwise be prone to abuse drugs or alcohol. Sometimes treatment providers can incorporate cultural beliefs into treatment programs, or maybe these beliefs can serve as a beacon for our efforts toward change.

Texas Culture

Given that Texas is large and populous, it is hard to define its culture. The state’s long history and several ethnicities also make it difficult to define culture in the state. But generally speaking, Texas culture includes elements of southern culture as well as the ranching and cowboy culture. Since Texas is a melting pot for many ethnicities, its culture is complex and multifaceted.

Some areas of southern Texas have multiple ethnic groups with varying attitudes toward alcohol. Researchers have studied how culture related to drinking among college students in the state. They determined that the students were mostly influenced by their cultures and ethnicities.

Anglo American students tended to drink in groups compared to their Mexican American counterparts in the studies. There were differences in patterns of behavior between both groups and differences in behavior between genders. The researchers concluded that these behaviors were keys in the future education of addicts and in addressing the issue of substance use disorder.

Acculturation is the degree with which one assimilates to a dominant culture. Some evidence shows that people who adopt non-native cultures have higher incidences of alcoholism. This may be partly because traditional societies viewed alcohol use as more of a conflict resolution and integrative effort. In modern culture, people often see alcohol use more as an individual experience, so it is a more asocial and pathological phenomenon.

Alcohol and Substance Use Disorder Treatment

Viewing alcohol use as an asocial and pathological phenomenon may make using the substance easier for those seeking to self-medicate. Traditional cultures often included rules and convictions that discouraged the abuse of these substances. While it may not be able to restore such rules or recreate the societies, we can adopt aspects of the culture of Texas to address substance use disorder:

Adventure Therapy

Adventure therapy can be described as the application of wilderness therapeutic tactics that are informed by empirical data. This type of treatment has been found to be effective in addressing substance use disorder in adolescents and teens. Elements of Texas culture can be incorporated into the treatment protocol to appeal to different social groups in the area. There are already resorts adopting elements of cowboy culture to help treat fear and anxiety.

Sports Therapy

Sports is another dominant aspect of Texas culture. Many Texans like to play football or follow their favorite football teams. Other sports such as baseball, basketball, auto racing, and soccer have significant followings in different parts of the state. Sports can be incorporated as physical activities in alcohol and substance use disorder treatment programs. Exercise can reduce alcohol, nicotine, and illicit drug dependence. Taking advantage of the interest that people have in these sporting activities can help draw young people and other people into drug and alcohol rehabilitation.

Nutritional Therapy

Addicts often neglect to pay attention to the foods that they eat. On many occasions, they skip meals in order to find or pay for their next fix. Or, their substance use disorder may reduce their appetites. Skipping meals deprives people of vitamins, minerals, and other important nutrients. Nutrition is therefore important for those undergoing recovery. Part of the Texas culture is its southern and Mexican cuisine. Specific food can be incorporated into the diet of an addict undergoing recovery. The southern menu has many delicious offerings for anyone looking to adopt a healthy diet.

Texas culture can play a prominent role in substance use disorder treatment and the adoption of positive patterns of behavior. Combined with dual diagnosis treatment and other evidence-based treatment protocols, the culture may compel many people to change. Elements of culture can encourage negative behavior, or people may adopt elements of Texas culture to play positive roles in substance use disorder treatment.