CHARLESTON, W.Va. — Brain science can help explain why people with serious addictions are so out of control, and why many addicts have trauma in their history.

Jessica Holton is a licensed clinical social worker and addiction specialist teaching in Charleston this week. She said in her practice, almost all of the addicts have trauma in their background, as well as Substance Abuse Disorder. Holton said this is because both addiction and trauma take over the limbic system - the animal part of the brain - bypassing the rational decision-making part.

"We often think that it's a choice, a moral failure. But really the science shows that the survival part of the brain, the limbic system, actually gets hijacked for those who have a true addiction,” Holton said.

Addicts sometimes say it's as if they've lost control of their own hands. Holton describes that as a symptom.

She'll be in Charleston for the Spring Conference of the National Association of Social Workers, West Virginia. That conference starts Wednesday. It's the largest event of its kind in the country. This year's schedule also includes discussions of foster care and social work in schools.

The limbic system controls pleasure and fear, and the out-of-control impulses known as the fight-or-flight response we experience when threatened. Holton said for those experiencing a trauma, or reliving one, the limbic system is pumping out fear messages that can override everything else.

She said drugs - at least at first - make the system put out pleasure messages. That's part of why people with post-traumatic stress disorder are vulnerable to Substance Abuse Disorder.

"Addiction tends to help people numb out and helps them to avoid,” Holton said. “In trauma, that same part of the brain works in overdrive. So it makes sense as to why when the brain is overreacting and over-responding and everything is a threat, substance use and trauma tend to go hand in hand."

Fairly quickly, serious substance abuse can overwork the limbic system's ability to create pleasure, which is why addicts say they no longer enjoy it. They just take substances to avoid withdrawal, a big part of which is the limbic system sending out fear messages.

Holton said the good news is that even if addiction can't be cured, an addict's limbic system can return to a state closer to normal after some months sober.


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COLUMBUS, Ohio - The holiday season has officially started, and one group is encouraging Ohio parents to make a special effort to check in with their teens to help them avoid risky behaviors.

With days off school, parties and distracted parents, experts say underage drinking tends to increase during the holidays. Rick Birt, president and chief executive of Students Against Destructive Decisions, said alcohol is the most widely used substance among teens, with 14 the average age for a first drink. He encouraged parents to set ground rules to manage expectations, and to not make discussions about risky behaviors as "one and done."

"We've talked with parents all across Ohio who try to have regular, routine check-in," he said. "Maybe when you're driving 'em to the bus stop, go beyond the 'How's school?' conversation; dig into the 'How are you feeling?' The more that you talk with your young person, the more able they are to have that ongoing conversation with you."

Because risk-taking is a typical part of teenage development, Birt recommended avoiding scare tactics. He said the best conversations focus on education about healthy choices and how to make smart decisions in the face of peer pressure.

Other important topics to touch on, Birt added, include the illegal use of prescription medications, tobacco and marijuana. With medical marijuana legal in Ohio as well as efforts to legalize recreational use, Birt said, teens may have misconceptions about its dangers.

"The marijuana of today is not the marijuana from the '60s and '70s," he said. "It's been genetically modified and is much stronger. It is different depending on how it's ingested - whether it's smoked or used as a dab, or used in an edible or in some other way."

Birt also noted that it's important to keep a check on a teenager's mood.

"While the holidays are full of lights and glamour and special moments, and while we're oftentimes more together during the holidays, we don't always feel that way," he said. "They can be lonely seasons for many young people. There's anxiety, and all sorts of other things that come into play."

Parents who are concerned about a teen's mental health can contact their primary-care physician. Online resources are available, too, at nami.org, ohiosadd.org and preventionactionalliance.org.


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PORTLAND, Maine -- Maine's providers of substance-abuse treatment and some other behavioral-health services are seeing a major increase in reimbursement rates going into effect this month.

But advocates for mental-health support say many agencies are facing major workforce shortages and other crises that prevent them from billing at all with the new rates.

Oliver Bradeen is executive director of Milestone Recovery, a nonprofit helping people facing homelessness and addiction. It's one of the few medically monitored withdrawal centers in Maine, often known as detox centers.

"Even with the increased rates, we're still struggling with workforce, and I know that's a common theme with the added level of COVID being a challenge," Bradeen explained. "There's just such a nursing shortage that it's hard to attract new talent from the nursing field."

He said their detox is currently closed because of those staffing shortages. He added while the improved rates are a step in the right direction, it could take time for providers who've been struggling to use them.

Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, said the increase in demand during the pandemic, combined with the severe impacts on the workforce, are putting a huge strain on providers, and waitlists for services are growing daily.

She emphasized it is important the Department of Health and Human Services invest more of the federal relief funding into these services now, as well as begin the proposed regular review of MaineCare's reimbursement rates.

"It's all going to be really good for the system of care," Shaughnessy projected. "But the current reality of many agencies is the situation is pretty raw. And it needs some direct infusion of resources and support right now."

Jeff Tiner, chief program officer for clinical services at Catholic Charities Maine, said putting more funds toward substance-abuse treatment is the right thing to do to support Mainers, and saves taxpayer money on emergency services and the criminal-justice system.

Data shows nationally, more than 85% of the prison population either has a substance-use disorder or were incarcerated for something involving drugs or drug use.

"We see the overdose rates that have increased exponentially," Tiner observed. "I don't think there's anyone in my world that has not been affected pretty close to home for those losses. Investment in prevention and support and recovery is really well worth it, and is a smart as well as compassionate."

SACRAMENTO, Calif. - Saturday is National Prescription Drug Take-Back Day, when the Drug Enforcement Administration encourages everyone to clean out their old prescriptions.

Flushing prescription pills can poison the local water supply, so instead, people can drop their bottles off at 200 police stations and government offices across California.

Susanna Marshland, Northern California regional vice president for the Fred Finch Youth and Family Services Center in Oakland, warned that unused medications are a danger to children, especially teens.

"There was an increase in parents relapsing during COVID, and a simultaneous increase in isolation and loneliness for their children," she said. "Kids whose needs are not being met may themselves turn to use."

According to the California Overdose Surveillance Dashboard, more than 5,300 people died from opioid overdoses in the state last year, a 120% increase from 2018. In 2020, Californians filled more than 14 million prescriptions for opioids. Find the closest drug drop-off sites online, at TakeBackDay.DEA.gov.

Nationally, said state Attorney General Rob Bonta, drug overdoses killed more than 93,000 Americans in 2020, and two-thirds of them involved a prescription or an illicit opioid.

"These aren't just statistics. These aren't just numbers. These are real people and these are real lives," he said. "We're talking about 93,000 moms, dads, teens, loved ones - each with a story."

Bonta added that at the last Take-Back Day in April, authorities collected 48,000 pounds of unused medications in California and 800,000 pounds across the nation.