PULLMAN — Rewarding drug addicts for good behavior may not be a politically acceptable treatment option, but it could lead to better results than traditional methods.

John Roll, a professor and vice dean of research at Washington State University’s School of Medicine, discussed the psychology of addiction during a presentation at the Foley Institute on Tuesday afternoon.

Although biology and genetics have a lot to do with addiction, Roll suggested the environment in which someone lives — the situations they find themselves in, the type of opportunities they have and the behaviors they observe — may be even more important.

“Are the opioid or (methamphetamine) epidemics really about drugs? I’m not sure they are,” he said. “It may not be about opioids or (methamphetamine) as much as it is about the environment. As long as people feel despair or lack hope, it’s human nature that they’ll try to address that. They look for a way out.”

Drugs like heroin, cocaine and meth — drugs that lead to addiction and abuse — tend to be powerful “reinforcers,” Roll said. They provide a sense of euphoria and invincibility, serving as a bright spot in an otherwise bleak existence.

Consequently, the most successful addiction treatment programs look for ways to reduce that reinforcement effect, or replace it with healthier alternatives.

For example, Roll cited clinical trials in which individuals were rewarded with small cash vouchers or prizes each time they passed a drug test. The incentives encouraged participants to stick with the treatment program and abstain from drug use for substantially longer periods of time, he said, when compared with “treatment as usual” alternatives.

“It’s a great way to treat addiction,” Roll said. “It doesn’t require a lot of training, it’s scalable (in size) and it’s cost-effective. I think it should be a front-line treatment option.”

The problem, he said, is that lawmakers perceive it as “paying people to do what’s right.” The federal government also resists this approach because it looks like people are being paid to attend, which constitutes Medicaid fraud.

Spokane Health Officer Bob Lutz, who spoke about the opioid epidemic during Tuesday’s meeting, noted that “harm reduction” initiatives such as safe consumption sites, medically assisted treatment and needle or syringe exchange programs can reduce some of the harmful complications related to drug use.

As with the incentive programs, he said, they often lack political support. However, one definition of public health is that it’s the actions people collectively take to assure the conditions in which people can lead healthy lives.

Environmental and social factors play a major role in determining who will be susceptible to addiction, Lutz said. “I think we have a collective call to improve the environment in which people live, work and play.”

Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.