Opioid Misuse in Appalachia

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.

Lisa Michele Shannon is Professor of Social Work in the Department of Sociology, Social Work, and Criminology and Visiting Professor in Public Administration and Policy at Morehead State University, USA.
Shondrah Tarrezz Nash is Professor of Sociology at Morehead State University, USA.

List of Illustrations
List of Tables
List of Contributors
Acknowledgements
Foreword, Justice Mary Noble, JD
Preface
Part I. Backfire: Opioids' Pervasion into the Mind, Body and Region, Shondrah T. Nash, PhD., & Lisa M. Shannon, PhD., MSW
Chapter 1: Waves that Almost Drowned the Mountains: The Opioid Crisis in Appalachia, Carl Root, PhD
Chapter 2: Short and Long-Term Physiological and Psychological Effects of Opioids, Daryl L. Richie, PhD, Cassandra D. Gipson PhD., & William W. Stoops, PhD
Clinical Memoir: Cocaine in the Urine Blues, Ann Colbert, MD, MPH
Part II. A Singe upon Hearth and Home: Opioids' Impact on Children, Families & Communities
Lisa M. Shannon, PhD., MSW, & Shondrah T. Nash, PhD
Chapter 3: The Public Health Lens of Substance Use Disorder in Rural Communities: Meeting People Where They Are and Not Leaving Them There, Deirdra Robinson, PhD & JoAnn Fraley, MSW
Chapter 4: Heritage, Harm, and Hope, Laken Gilbert Albrink, JD
Clinical Memoir: Collateral Damage, Ann Colbert, MD, MPH
Part III. Battling Back the Flames: Efforts to Contain the Opioid Epidemic, Shondrah T. Nash, PhD., & Lisa M. Shannon, PhD., MSW
Chapter 5: Responding to Crisis: Social Service and Treatment Agencies at the Front Lines of the Opioid Epidemic in Appalachian Kentucky, Monica Himes, PhD, LCSW
Chapter 6: Kentucky Specialty/Problem-Solving Courts, Connie M. Payne, JD, Connie M. Neal, MSW, & Lisa M. Shannon, PhD, MSW
Chapter 7: Kentucky's Opioid Approach: Law, Regulation, and Public Health, Dustin Nelson, PhD, JD
Clinical Memoir: Intersectionality and Healthcare Workers, Ann Colbert, MD, MPH
Part IV. Exploring Stories of Hope and Recovery, Lisa M. Shannon, PhD., MSW, Shondrah T. Nash, PhD., Morgan Taylor, BSW, & Jason White, BSW
Chapter 8: Rising Up from the Ashes: Pathways of Hope to Recovery, Lisa M. Shannon, PhD, MSW, Shondrah T. Nash, PhD., Morgan Taylor, BSW, & Jason White, BSW
Index