Coal’s role in Appalachia’s drug problem

July 26, 2013 by Ken Ward Jr.


The other evening, during a panel discussion following a Charleston screening of the film “Oxyana,”, there were apparently some questions raised about the coal industry’s role in the prescription drug abuse crisis in the Appalachian coalfields.

Dave Boucher over at the Daily Mail tweeted about it, and the subject got a brief mention in his paper’s print story on the event:

Mari-Lynn Evens, a documentary filmmaker whose work deals with coal mining, pointed out the link between the state’s history of heavy industry and the high rates of prescription drug abuse.

“Are you interacting with the coal industry, which is obviously a key component of this, on doing anything to tackle the problem?” she asked.

[Supreme Court Justice  Brent] Benjamin discussed the relationship between coal and drugs and mentioned how pain pills had been prescribed in the past to help miners cope with the pain of the jobs. Benjamin didn’t directly answer the question.

“That’s a law enforcement thing and I’m on the judicial side,” he said. “We just get the results.”

West Virginia Public Broadcasting’s Dave Mistich also mentioned it in his coverage, with some comments from Kim Miller, Director of Development for Prestera Center, a mental health and addiction services provider:

“West Virginia has a long history of heavy industry. So, for us, we’ve made livings in coal mines, and timber industry, and steel factories,” Miller responded. 

 “There’s a high incident of worker injury associated with those occupations.  So, as people are injured, the incentive is to get them back to work and the best way to do that is to help them control their pain.”

Now, I haven’t seen the film yet — so I’m not going to get into that at this point. And it’s a stretch to blame the drug problems facing our coalfield communities on any one factor. It’s more complicated than that, and I am certainly not an expert. But I thought it might be worth noting a few things that are out there in the literature about the connections between the region’s dependence on the mining industry and the problems being experienced now with drug abuse.

For example, there was this in a 2002 U.S. Department of Justice report titled Kentucky Drug Threat Assessment:

In the eastern coal mining counties of Kentucky, the large-scale diversion and abuse of painkillers are particular problems. In the past coal miners spent hours each day crouched in narrow mine shafts. Painkillers were dispensed by coal mine camp doctors in an attempt to keep the miners working. Self-medicating became a way of life for miners, and this practice often led to abuse and addiction among individuals who would have been disinclined to abuse traditional illicit drugs.

In 2006, a report called Substance Abuse in Rural and Small Town America, compiled by the Carsey Institute at the University of New Hampshire, had this to say:

OxyContin, or “Hillbilly Heroin,” is ravaging rural communities across the country. Maine, Kentucky, and West Virginia are particularly hard hit. One reason may be that doctors originally prescribe the drug to legitimately treat chronic back pain—a result of long years of heavy labor in logging, farming, mining, or working in factories and mills. As those businesses downsize or close completely, people are left with no jobs and no hope. A natural release for many is to abuse their prescription drugs. Once hooked, treatment is diffi cult due to the isolation of rural communities and over-burdened health facilities.

A more recent article, published in 2012 by the journal Health Promotion Perspectives, explained:

Regional industry in Southwest Virginia is predominately logging and coal mining; both industries provide many work opportunities but also provide workers with injuries necessitating legitimate prescriptions for pain. Injuries that occur among workers in these industries may lead to chronic medical problems, including pain, the treatment of which includes prescription of medications with addiction potential. Because of the high rates of workforce related injuries, a lot of people in the area are considered physically disabled from work related accidents and are getting and using pain medications.

This article also emphasizes the broad range of factors involved in the region’s drug problems:

A constellation of conditions have led to the epidemic of prescription drug abuse in Southwest Virginia, including poverty, unemployment and work-related injuries, besides, public health education programs on the dangers of prescription opiate misuse and abuse are urgently needed.

And a summary report from the Appalachian Regional Commission found that:

Comparatively low education levels, high rates of unemployment, and job related injuries are closely linked to abuse of alcohol, illicit drugs, and prescription medications.

Those are just a few examples, and are offered just to makes sure folks understand that it’s not a far-out or new idea that there are connections between our region’s dangerous industries — and the boom-bust nature of those industries — and the drug abuse problems now been suffered by far too many of our families.

We’ve written before about West Virginia’s new coal-mine safety law, and how the Tomblin administration and the coal industry pushed to cram drug-testing requirements into the post-Upper Big Branch Mine Disaster legislation, despite the lack of any connection whatsoever between what happened at UBB and drug use by coal miners (see here, here and here).

What was especially problematic about the approach taken by the governor and West Virginia lawmakers was that they insisted on language to require drug-testing of coal miners, but then did not include any companion requirement that mine operators try to help their employees receive treatment and other assistance to deal with the problem (see here and here).

And it’s also worth remembering, in any discussion of how West Virginia leaders are dealing with the state’s drug abuse problems: A task force of experts urged Gov. Tomblin and lawmakers to increase taxes on tobacco and alcohol to help fund increased treatment efforts around the state. The governor and the Legislature declined to do so.


5 Responses to “Coal’s role in Appalachia’s drug problem”

  1. I helped organize the screening of Oxyana. I seem to recall that Ms. Evans articulated specifically that she had seen coal miners waiting in line for painkillers at the behest of coal companies (or their doctors, I forget what she said exactly). Also, in the film, a dentist in Oceana says it was his impression that coal companies used to tell their doctors to basically give the miners whatever it took to keep them working. I don’t know if that is commonplace or not, but it would be interesting to know.

    We focused our panel discussion on solutions to the prescription drug abuse problem that are currently working, but examining the roots/cause of prescription drug abuse would probably help find other, new solutions and would have also been a good topic if we had more time.

    Anyway, I wanted to give that detail from both the film and discussion for those not there and/or who have not seen Oxyana yet.

  2. Cassandra Stalzer says:

    I grew up in a coal camp just outside of Oceana and my grandfather and his coworkers were not over-prescribed pain medication. On a recent visit to Oceana, I was shocked at the lack of nonprofit infrastructure and a complete absence of philanthropy-which together are often the systems that support treatment, recovery, prevention, education and social innovation.

  3. Ralphieboy says:

    I believe that the overriding cause for drug abuse (in West Virginia at least) is the overwhelming sense of hopelessness that people feel about their future. I grew up in McDowell Co. and left shortly after high school because there just were no opportunities for young people there. I never went back there to live again, and now it’s much worse there than when I left in the early 1970’s. When I do go back to McDowell Co. to visit, I see the devastation that a dying coal industry, unemployment, floods and a drastically declining population have wrought upon the landscape and the people there; and many of them, old and young, have turned to prescription drugs for relief. Unless WV can break it’s dependence on coal and diversify it’s economy to provide meaningful work for it’s residents, this trend will continue to spread like cancer to all of the state.

  4. Mark says:

    There is a problem with prescription drugs and illicitly synthesized derivative drugs in our state. However, we should not focus too narrow a lens on our small corner of the earth.

    These same drugs are as present and destructive in other countries, as they are here at home. In other words, this is not just a uniquely Appalachian, coal field problem.

    These drugs are as present and desctructive in countries and communities that have absolutely nothing to do with coal.

  5. Mari-Lynn says:

    In a 2008 CDC report, West Virginia has the highest rate of prescription drug overdose deaths in the US. In five years (1999-2004), deaths resulting from drug overdose in West Virginia rose 550%. This was the largest increase of any state in the country.
    In 2009, the rate of drug-induced deaths in West Virginia was higher than the national average. From 2004-2008 three West Virginia counties ranked in the top ten for rates of drug poisoning deaths in the nation. These counties include the highest (58.7 deaths per 100,000 population in Wyoming County), the 2nd highest (58.1 deaths per 100,000 population in McDowell County), and the 8th highest (45.1 deaths per 100,000 population in Logan County).
    Recently a WV State Government web site of Military Affairs and Public Safety quoted State Police Superintendent Jay Smithers saying,“Without question, prescription drug abuse has become an epidemic in West Virginia,” “In southern counties ,you can actually call it a plague.”
    The concern for drug use at the coal mines was confirmed by Chris Hamilton, a senior vice president for the West Virginia Coal Association. Hamilton also cited several recent accidents at coal mines in which drugs or alcohol played a role.
    It seems that it would be beneficial to involve the coal industry with all stakeholders in resolving drug use in West Virginia, most prevelant in the ‘coal fields’ of the state.

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