From the Front Lines of the Appalachian Addiction Crisis

Stories from doctors, nurses, and therapists dealing on a daily basis with the opioid crisis in Appalachia should be heartbreaking. Yet those told here also inspire with practical advice on how to assist those in addiction, from a grass-roots to a policy level. Readers looking for ways to combat the crisis will find suggestions alongside laughter, tears, and sometimes rage. Each author brings the passion of their profession and the personal losses they have experienced from addiction, and posits solutions and harm reduction with positivity, grace, and even humor. Authors representing seven states from northern, Coalfields, and southern Appalachia relate personal encounters with patients or providers who changed them forever. This is a history document, showing how we got here; an evidenced indictment of current policies failing those who need them most; an affirmation that Appalachia solves its own problems; and a collection of suggestions for best practice moving forward.

Wendy Welch is the executive director of the Graduate Medical Education Consortium of Southwest Virginia where she advocates for social justice and policy planning in equal measure. She lives in Wytheville, Virginia.

Edited by Wendy Welch
Foreword by Lauren Sisler
Format: softcover (6 x 9)
Pages: 227
Bibliographic Info: bibliography, index
Copyright Date: 2020
pISBN: 978-1-4766-8226-6
eISBN: 978-1-4766-4133-1
Imprint: McFarland
Series: Contributions to Southern Appalachian Studies

Acknowledgments viii

Foreword by Lauren Sisler 1

Preface
WENDY WELCH, PH.D., MPH 3

5,000 Year Ghazal
MOLLY O’DELL, MD, MFA, and WENDY WELCH, PH.D., MPH 7

Six Minutes
THERESA ANN POLING, FNP 9

Perspectives from a Prescriber
MANJu PuSHKAS, MD 27

Injecting Hope with Sublocade
DALEEN BERRY 42

Rockabye
RONDALYN VARNEY WHITNEY, PH.D., OTR/L, FAOTA 54

This Is Your Body on Drugs
TAUNA GuLLEY, PH.D., FNP- BC 59

Hoofbeats of the Zebra
SUSAN M. HAMRICK, AASRT, RT, ARDMS, RVT, RDCS 71

The Seeker and the Provider
BRANDON WHITED, LPN 75

City of Solutions
LYN M. O’CONNELL, PH.D.; JODI MAIOLO, MPH, and STEPHEN PETRANY, MD 84

A Clinician’s Guide to Changing Your Mind
ISSAIAH WALLACE, MSN, PMHNP- BC 105

Why Addiction Care Is Primary Care
MELISSA L. ZOOK, MD, FAAFP, FASAM, AAHIVS 121

Community Is the Vehicle to Recovery
TANNER CLEMENTS, M.DIV., and ANDREA D. CLEMENTS, PH.D. 135

Mountain Doc
WILLIE DALTON, BS 156

How We Got Here and How We Can Get Out of Here
RANDALL E. JESSEE, PH.D. 164

The Bad
DEBORAH GOLD, in Conversation with Misty 176

Who Will Leave Harlan Alive?
MARY JEWELL ALLEN, DO 194

White Coat Man…
MARCUS OGLESBY, CREEK DON’T RISE BAND 207

Data Make You Credible, but Stories Make You Memorable
MICHAEL MEIT, MA, MPH 209

About the Contributors 213

Index 217

• “From the Front Lines of the Appalachian Addiction Crisis is an insightful first-hand look inside our nation’s struggle to address the terrible crisis impacting our small towns and rural communities. It posits innovative policies and solutions, provided in the context of real world heartbreaking examples. This is a true insider’s perspective, providing a blueprint forward for practitioners, community leaders, and policymakers alike.”—Alan Morgan, CEO of The National Rural Health Association

• From the Front Lines of the Appalachian Addiction Crisis is vital to understanding this country’s opioid crisis. It is an important collection for explaining what’s happening, and how some of our best hearts and minds are processing the collective trauma of the painkiller epidemic. By focusing on the reflections of health care providers and their direct experience on the front lines of the crisis, these essays shine warm light on how substance use has affected both patients and caregivers. From the Front Lines is the best kind of storytelling history—personal, analytic, immediate, and increasing in value as we move farther from the era described.”— Robert Gipe, author of Weedeater and Trampoline