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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A new statewide program in Kentucky is providing addiction advocacy groups and recovery centers with flexible funding to focus on resource equity and expansion of services.

Gary Biggers, program operations manager for the nonprofit Voices for Hope, said the nearly $50,000 grant will be used to provide staff with training centered on listening, empathy, and nonjudgmental communication when working with diverse populations. The group will also work with communities of color to provide education on overdose, substance use trends, and community resources for recovery.

He pointed out large gaps remain in awareness about recovery services and harm reduction in Black and Latino populations.

"It affects all communities, all diversities, all racial backgrounds and ethnicities," Biggers outlined. "Everyone should have those same opportunities and be educated on the resources if they happen to suffer from substance use disorder."

State data show more than 2,100 Kentuckians lost their lives to a drug overdose last year, a decline of more than 5% compared with the previous year and the first decline since 2018. The majority of overdose deaths involved opioids, and fentanyl continues to be a driving factor, accounting for more than 70% of overdose deaths nationwide in 2022. Methamphetamine was also a significant contributor to deaths caused by drug overdoses.

Katie Vogel, director of development for the Hope Center in Lexington, said her organization's $50,000 grant offers a chance to enhance existing services and bring caseworkers into communities. She noted money will go toward a Mobile Case Coordinator who will engage with at least 25 people every month who use drugs, connect them with harm reduction services, and provide referrals to medical care.

"Our mobile outreach is out in the Fayette County, Lexington community five days a week," Vogel explained. "Parked in a different church downtown or a different downtown location every day, to provide resources."

Research shows people who use drugs perceive mobile outreach as a benefit to their communities and themselves by improving access to care, without the stigma associated with walking into to a clinic or drug treatment center.


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The opioid crisis continues to plaque communities across Ohio, and according to the state Department of Job and Family Services, more than 3,000 Ohio children were removed from their homes because of parental substance use in 2022.

A silver lining is a program called START, which provides wraparound services to families and is seeing high success rates.

Fawn Gadel, director of the Ohio START program for the Public Children Services Association of Ohio, said when a family interacts with Children's Services due to parental substance use, Ohio START steps in to pair the family with a caseworker and family peer mentor.

"The family peer mentor is a person that is in long-term recovery from substance use disorder, and also has experience in children's services themselves," Gadel explained.

Children affected by parental substance use are at higher risk of being placed in foster care and experiencing trauma associated with family separation. During the past six years, Ohio START has assisted more than 1,000 families on the path toward recovery.

Aimee Clemson-Rich, a former family peer mentor and now START caseworker, said the program has a more than 80% success rate in Ashtabula County, where she works. She explained prior to the program, Children's Services would immediately take children out of the home and ask questions later.

She noted START aims to work directly with affected families as a collaborator in reaching the goal of a healthy and safe household.

"The safety plan is where the parent gets to pick a kinship provider," Clemson-Rich outlined. "A family member or a friend that will take care of their kids while the person with substance use disorder goes to treatment."

Clemson-Rich added the stressors of the pandemic, mental health issues and financial pressures are pushing more families into crisis. She pointed out in Ashtabula, START is operating at max capacity.

"We are constantly having to turn families away from this program because there's just not enough caseworkers for the number of intakes that come in," Clemson-Rich stressed.

For her work, the Public Children Services Association of Ohio recently awarded Clemson-Rich the 2023 Child Advocate of the Year award.

This week, Gov. Jim Justice announced five new appointments to the West Virginia First Foundation, the private foundation responsible for the statewide distribution of opioid settlement funds.

Advocates are calling for the money to be used for medication for addiction treatment and harm reduction services - such as needle exchanges, naloxone, and overdose prevention centers.

Mary Newlyn, executive director of the West Virginia Hope in Action Alliance, said expanding housing and wraparound support services for people who use drugs and people with drug-related convictions, would help stabilize communities and families.

She pointed out most substance-use disorder funding is not funneled toward those types of supports.

"Once a person has reached a state of sobriety, they need community support and access to the healthy coping techniques they obtained during treatment," Newlyn explained. "These communities are built in transitional and recovery housing."

According to the Office of Drug Control Policy there were at least 1,300 drug overdose deaths in West Virginia in 2020, a 51% increase compared to 2019. This year, there have been more than 5,000 reported EMS responses for suspected overdoses.

Tricia Christensen, director of policy for the nonprofit Community Education Group, said states should be thinking creatively about how to best use the funding to help stem the tide of substance abuse. She pointed to mental health resources, youth prevention programs and community programs focused on forging a life in recovery.

"How do we invest in our communities to really think about opportunities for kids as they're growing older?" Christensen asked. "Opportunities for those kids' parents now, right? Because we know that this is a generational issue."

The Mountain State has received an estimated $847 million from lawsuit payouts involving major pharmacy chains, drug manufacturers, drug distributors, and pharmaceutical consulting firms.This week, Gov. Jim Justice announced five new appointments to the West Virginia First Foundation, the private foundation responsible for the statewide distribution of opioid settlement funds.

Advocates are calling for the money to be used for medication for addiction treatment and harm reduction services - such as needle exchanges, naloxone, and overdose prevention centers.

Mary Newlyn, executive director of the West Virginia Hope in Action Alliance, said expanding housing and wraparound support services for people who use drugs and people with drug-related convictions, would help stabilize communities and families.

She pointed out most substance-use disorder funding is not funneled toward those types of supports.

"Once a person has reached a state of sobriety, they need community support and access to the healthy coping techniques they obtained during treatment," Newlyn explained. "These communities are built in transitional and recovery housing."

According to the Office of Drug Control Policy there were at least 1,300 drug overdose deaths in West Virginia in 2020, a 51% increase compared to 2019. This year, there have been more than 5,000 reported EMS responses for suspected overdoses.

Tricia Christensen, director of policy for the nonprofit Community Education Group, said states should be thinking creatively about how to best use the funding to help stem the tide of substance abuse. She pointed to mental health resources, youth prevention programs and community programs focused on forging a life in recovery.

"How do we invest in our communities to really think about opportunities for kids as they're growing older?" Christensen asked. "Opportunities for those kids' parents now, right? Because we know that this is a generational issue."

The Mountain State has received an estimated $847 million from lawsuit payouts involving major pharmacy chains, drug manufacturers, drug distributors, and pharmaceutical consulting firms.