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    From the Top of the Mountain to the Rock Bottom of Addiction: The Opioid Epidemic that Devastated Appalachia

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    The American opioid epidemic (1997 - present) has continued to ravage the United States, with its most acute impacts being witnessed in the towns and counties of Appalachia. OxyContin (a semi-synthetic opioid) was released by Purdue Pharma in 1996 and is largely to blame for the epidemic, as its release overlapped with changes in the medical system that encouraged the prescription of opioids for acute and even moderate pain management. Meanwhile, the Appalachian Mountains were beginning to see changes, as a new type of mining, Mountaintop Removal Mining (MTRM), introduced in the 1970s, was changing the economic landscape of the region. This thesis examines the connection between the environmental degradation caused by MTRM and its effect on the opioid epidemic. It was predicted that MTRM propagated the opioid epidemic in Appalachia due to its destabilization of the local economy and the effects that the environmental damage had on the community’s mental health. In order to test this, data was collected from a variety of databases and supported by additional field research. Data were analyzed in Excel and PAST4 for four primary variables; opioid overdose rate, number of coal mining jobs, unemployment rates, and rates of depression. While not all tests demonstrated statistical significance, published literature supports the idea that high unemployment rates due to MTRM contributed to a lack of financial stability and a sense of desperation that exacerbated drug diversion. Additionally, psychoterratic syndromes (earth-related illnesses) due to environmental destruction played a role in the reliance on OxyContin. The complexities present in the development and perpetuation of the opioid epidemic not only serve as a reminder of the connections between the natural world and human health, but as a way to hold the corporations and policies at play accountable for the harm they caused