Opioids Decimated a Kentucky Town. Recovering Addicts Are Saving It.

The Free Press, Sam Quinones, February 6, 2024

After the collapse of coal mining and the rise of the opioid epidemic, Hazard, Kentucky, seemed finished. Then locals started to rescue it.

In early 2020, Mandi Fugate Sheffel, 42, opened a tiny bookstore in her hometown of Hazard, in eastern Kentucky. Everyone thought she was crazy.

Downtown Hazard was a forbidding place to start any business, much less a bookstore. The coal mines that once supported the area had closed over the past few decades. Many brick buildings from Hazard’s heyday were gone, bequeathing a gap-toothed look to Main Street. The rest were empty or occupied by attorneys and bail bondsmen.

What’s more, Fugate Sheffel couldn’t afford a website or employees. She had never run a business before. And she had a complicated personal history to wrestle with.

But she loved to read—particularly contemporary Appalachian authors like Silas House, James Still, and Gurney Norman, who told stories that felt real to her. She figured others in town were tired, like her, of driving two hours to Lexington to buy books. 

So, on January 30, she opened Read Spotted Newt in a 250-square-foot space—the size of a small bedroom.

I met Fugate Sheffel last spring when I visited Hazard (population 5,000) for the first time. I came to speak about my book, The Least of Us, about America’s drug-addiction epidemic. I had heard about the town, and had formed an image of it as the buckle on eastern Kentucky’s opioid belt. 

From Fugate Sheffel, though, I heard another story—one that I heard elsewhere in eastern Kentucky, and in West Virginia and southwest Virginia and the southern tier of Ohio.

“When you don’t have industry, you’re having ecological disaster and a drug epidemic—you would think all those things would get us to a place where the town would be uninhabitable,” Fugate Sheffel told me. “But that’s not what I’m seeing at all. I’m seeing a lot of people rally.”

The loping hills of eastern Kentucky are studded with scores of towns like Hazard—and nearby Prestonsburg and Pineville and Corbin—that, over the centuries, emerged in the valleys and along its rivers. 

The beginning of these places stretched back at least to the middle of the nineteenth century and the first coal mines, mostly in the Allegheny Mountains, in the eastern part of the state. By the early twentieth century, coal dominated the region, with roughly 700,000 men and boys toiling in the mines of Kentucky and neighboring West Virginia. 

For decades, there was stability. Lots of jobs, no drugs. (In fact, Kentucky’s state House of Representatives passed a bill banning alcohol in 1914, four years before Prohibition. The bill died in the state Senate.)

In the 1990s, “as one declined and things got worse, the other increased and things got worse,” Les Stapleton, the mayor of Prestonsburg (population 4,000), 35 miles northeast of Hazard, told me about the correlation between jobs and drugs.

Larger forces over which locals had little or no control exacerbated things: the rise of natural gas, new environmental standards, our shifting political and cultural landscape.

By the early 2000s, the region had become the epicenter of the new opioid epidemic, which spiraled out of the Big Sandy River and flowed through eastern Kentucky, West Virginia, and southwest Virginia.

Downtowns emptied out. Buildings were abandoned. About the only new local businesses were “pill mills”—clinics that prescribed huge quantities of prescription painkillers. In the little evangelical churches, they prayedfor an end to “hillbilly heroin.” 

Hazard, the seat of surrounding Perry County, had thrived for over a century with the mines, but when the mines closed the town mostly closed down, too. By the late 2010s, Perry County was the worst hit county in the United States when it came to opiates. 

Hazard, like so many of these places, took on a haunted feeling, as if the whole world that used to be here—people, storefronts, churches, marching bands, Friday night football, bowling leagues, quilting clubs—just disappeared.

But then, weirdly and unexpectedly, at the same time that everything was falling apart, things started to get better—and that old world started, very tentatively, to build itself back up.

In the past few years, some 43 businesses have opened in Hazard, creating 171 new jobs, said Bailey Richards, the town’s coordinator of downtown development. That includes a toy store, a café, a women’s boutique, a quilt and apparel place, and a smoothie shop. A longtime restaurant just moved downtown.

The population, which declined for most of the latter half of the twentieth century, now appears to be inching up: in 2010, there were just south of 4,500 people in Hazard; by 2021, that figure had jumped by 500 or so people, and everyone thought it would keep rising. That growth was driven mostly by outsiders—new families, mostly from cities in Kentucky, in search of a better future, and immigrants, including a nascent Latino community.

Shane Barton, the downtown development coordinator at the University of Kentucky’s Community and Economic Development Initiative, went so far as to call Hazard “a hip destination for young people.”

It was hard to say why this was happening. Gradually, people were becoming more aware of the crisis of Appalachia and were doing things trying to help. (President Bill Clinton paid a visit to Hazard in 1999 to bring attention to its mounting woes.) Covid pushed people to move out of the cities. And there were the recovering addicts; they weren’t expensive to hire if you needed a barista or someone to stock your shelves or paint your walls, and they were eager to work, to live.

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