Opioid Misuse in Appalachia : A Fire on the Mountain

A critical look at the slow-burning public health disaster transforming the lives of Appalachian Kentuckians.

Opioid Misuse in Appalachia: A Fire on the Mountain brings readers to the front lines of the crisis through interdisciplinary research and first-hand perspectives, tracing the epidemic’s rise from Kentucky’s underground drug economy to its far-reaching effects across mind, body, and community. Drawing on insights from recovery specialists, medical professionals, social service practitioners, activists, and scholars, the volume examines the physiological and psychological challenges of addiction alongside the social conditions, institutional barriers, and inequities that sustain it. Contributors explore the ripple effects on individuals, families, children, and rural support systems, as well as the state’s criminal justice responses, including legislation, custody policies, and drug courts, and conclude with first-hand accounts of addiction, loss, resilience, and recovery. Together, these perspectives reveal not only the depth of the crisis but also why meaningful, coordinated responses are essential to supporting lasting recovery and regional renewal.