Substance use and abuse is not a uniquely Appalachian problem, but it remains a prevalent social problem for the geographical region. Kentucky has been one of the central states experiencing generations of substance abuse, ranging from methamphetamines to OxyContin to heroin. Eastern Kentucky, which includes a portion of Central Appalachia, has been a focal point for the proposed war against substance use. What remains undemonstrated in studies is exactly how substance abuse differs between the Central Appalachian counties of Eastern Kentucky and the remainder of the state, if any difference exists at all. In this study, the researchers examine how drug mortality, nonfatal overdoses, emergency room substance abuse diagnoses, and inpatient hospital substance abuse rates vary between Appalachian and non-Appalachian counties in Kentucky. Results indicate that there is a marginal difference in drug fatalities and a statistical difference in both emergency room and inpatient diagnoses of substance abuse. However, the non-fatal overdose rate is nearly identical for Appalachian and non-Appalachian counties across the state. The authors argue this can be explained through Relative Deprivation Theory, persistent underdevelopment of Kentucky’s Appalachian counties, and medical use practices in the region. The researchers close with recommendations on reconsidering how substance use is treated.

Mentor Name

James N. Maples

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