As the opioid epidemic continues to ravage the country, addiction counselors are addressing risk factors and calling for better treatment options.

Joy Graham, a professional clinical counselor in Woodsfield, has 15 years of experience treating patients with addictions.

Graham said the biggest risk factor and predictor in the development of addiction is a history of childhood trauma.

“The more trauma history — abuse or neglect — the higher the risk for addiction. An addiction is all about numbing emotions you don’t want to feel. People who have gone through healthy development as a child, especially under the age of 5, are much less at risk. Those are people that had all their needs met, felt safe, loved and secure, and were able to develop a good self-concept, self-esteem and self-awareness,” Graham said.

A study was done in the 1960s that had rats in a cage with a choice of heroin- or cocaine-infused water and regular water. The rats were observed to drink the heroin/cocaine water until they overdosed.

Graham said there was a more recent study done that had the rats in an enriched environment, with socialization and stimulating activities available to them. In that study, the rats did not choose the heroin/cocaine water.

“It is loneliness, isolation and lack of hope that leads to addictions many times, and as financial struggles happen, that makes it worse. Monroe County is isolated and has a high rate of unemployment. There is not much here except isolation, poverty and joblessness, and we have a high rate of addiction,” she said.

She said that the opiate problem is getting worse because opiates bind to dopamine receptors, or “feel-good receptors” in the brain, so anyone can become addicted to opiates.

“Not everyone that drinks alcohol becomes an alcoholic because being alcoholic takes a certain type of metabolism. Alcohol is actually a depressant, but it affects the alcoholic as a stimulant and has the opposite effect. But anyone can become addicted to opiates,” she said.

Graham addressed the need for more treatment centers, long-term care, especially in rural areas such as Monroe County.

“Once addicted, people just use mainly to keep from getting sick. The nearest detox center to Monroe County is in Glen Dale. Once people go through detox, they come back here to the same lack of resources,” she said.

Graham is working with other addiction counselors across the state to develop a more holistic-based treatment system that can be more readily available to all communities.

“One of the reasons traditional treatment doesn’t work is because it is behavioral-based. It doesn’t treat the underlying trauma. When you work on the trauma, you heal the cycle of shame. Treatment needs to be focused more on emotional, social, spiritual and physical aspects,” she said.

Brandi Spaulding is a detox counselor and doctoral candidate with The Ohio State University in Columbus, and thinks the biggest risk factor for addiction is being “low-income,” as well as having experienced childhood trauma.

“We see that people most at risk are low-income. Generally that population lacks proper coping skills, and they often don’t have their basic needs met. Therefore, they live under high stress. And so many children from low-income families have experienced trauma. And they lack proper health care and drug treatment opportunities, which makes it worse,” Spaulding said.

Spaulding believes the heroin and opioid epidemic has gotten so much worse and spread throughout every demographic because of the proliferation of prescription pain medications.

“It started getting out of control in the 1990s, and is definitely what started the heroin influx,” Spaulding said.

The National Institutes of Health website, drugabuse.gov, cites a study that found that of those who began abusing opioids in the 2000s, 75 percent reported their first opioid was a prescription drug, and among general population heroin data shows that nearly 80 percent of heroin users reported using prescription opioids prior to heroin.

“I don’t think there is anyone who is not at risk. We see people from all different backgrounds and types of family environments. All it takes many times is for someone to get hurt, and be prescribed an opioid pain medication. Many become addicted, and then are not prescribed the medication any longer, and they try to get the pills illegally for a while, then turn to heroin because it is very cheap,” Spaulding said.

Spaulding said a good solution to the opioid and heroin addiction epidemic would be for doctors to stop prescribing the pain medications.

“We need more treatment centers available to the entire population. Hospitals need to start putting small pop-up clinics in rural areas so more people have access to treatment. And treatment needs to be long-term.

“We need to be able to teach life skills — self-reliance, coping skills, personal relationship skills. Quitting a drug is a lifestyle change that needs to be supported. It takes longer than a three- to five-day detox,” she said.

Spaulding said it’s difficult to predict who will become addicted, although she believes genetic predisposition and environmental factors have something to do with the cause. “Using these drugs is kind of like playing Russian roulette,” she added.