The Sunday Read: ‘Opioids Ravaged a Kentucky Town. Then Rehab Became Its Business.’

The Daily

The New York Times

Daily News, News

4.4 • 102.1K Ratings

🗓️ 19 January 2025

⏱️ 45 minutes

🔗️ Recording | iTunes | RSS

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Summary

Ingrid Jackson had never lived in a trailer before, or a small town. She was born in Louisville, Ky., the daughter of a man with schizophrenia who, in 1983, decapitated a 76-year-old woman. Jackson was 1 at the time. In 2010, at 27, she was in a car accident and was prescribed pain pills. Not long after that, she began using heroin. Over the next decade she went through nine rounds of addiction rehab. Each ended in relapse. Her most recent attempt came in 2022 after her son was sentenced to life in prison for murder; he was 21. In eastern Kentucky, a region that is plagued by poverty and is at the heart of the country’s opioid epidemic, the burden of addressing this treatment gap has mainly been taken up by addiction-rehab companies. Many stand more like community centers or churches than like medical clinics, offering not just chemical but also spiritual and logistical services with the aim of helping people in addiction find employment and re-enter society.

Transcript

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0:00.0	My name's Oliver Wang, and I'm a contributor to the New York Times Magazine.
0:08.0	I started reporting the story about five years ago when I moved to eastern Kentucky during the pandemic.
0:16.0	It was a perfect respite during lockdown.
0:19.0	Endless hills and hidden streams.
0:22.4	The trees are spectacular in the fall.
0:25.7	But the region has a troubled past.
0:29.0	Many communities were established as single-company coal mining camps, company
0:34.1	company towns.
0:35.8	When the industry flagged and companies exited the area, high rates of poverty
0:40.4	were left behind, not to mention high rates of disability from the hazards of coal mining.
0:47.1	This created fertile ground for drug companies, like Purdue Pharma, to promote opioids, such OxyContin to doctors in the region.
0:57.8	And as we've seen over the past 25 years, opioid addiction rates in Appalachia have risen
1:03.1	higher than anywhere else in the country. There are now generations of people who are
1:09.0	addicted to opioids.
1:17.4	But while Eastern Kentucky is one of the places where you're most likely to die of a drug addiction, it's also one of the places where you're most likely to receive treatment for it,
1:23.5	regardless of your income or background, which is what set me off on this year's long reporting
1:29.9	journey and brought me to a local rehab company called Addiction Recovery Care, or ARC, for short.
1:39.8	ARC was founded in 2008, emphasizing the long-term aspect of addiction recovery.
1:46.6	People would be allowed to remain as inpatients for an extended period of time, sometimes more than a year.
1:53.1	They'd get counseling, medical treatment, housing, and job training.
1:57.7	And ARC would also often employ its patients once they graduated from rehab, even those with criminal records.
2:06.2	When I first came across the company in 2020, it had around 700 employees, half of whom were in recovery themselves.
	...

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