Over the last two decades, rural Appalachia has received considerable media attention due to its central position in the U.S. opioid crisis. Since the dawn of the crisis in the early 2000s, rural Appalachian communities have faced some of the highest rates of opioid use disorder and opioid overdose across the country. Nonetheless, pictures of disadvantaged rural communities in Eastern Kentucky, West Virginia, and Southwestern Virginia made headlines in both 2021 and 2022 for another devastating reason: significant flooding events that demolished roads and bridges in hollers, decimated homes, and shuttered local businesses. These floods have resulted from a combination of vulnerabilities: climate change-induced severe rainstorms, a landscape prone to flash floods due to the environmental destructions of coal mining, and poor infrastructure resulting from economic losses amid coal’s decline.
We know that external events can impact the individual health outcomes of people who use drugs. Most recently, considerable research has demonstrated how economic downfall and business closures during the COVID-19 pandemic increased rates of overdose and relapse. Yet social scientists have not adequately considered the impacts of environmental disasters on substance use outcomes. Nevertheless, there is reason to expect a close relationship between the two. After floods ravaged Eastern Kentucky during the summer of 2022, Kristina Brant (principal investigator) learned from past research informants that flooding had temporarily disrupted providers’ abilities to serve people who use drugs and people in recovery. Due to the predicted continuation of these disasters, understanding the impact of flooding events on substance use outcomes and the provision of substance use services is essential to mitigating the damage incurred by future floods.
Our investigation will be multi-method, combining qualitative fieldwork and statistical analysis to probe the impacts of these recent flooding events on substance use outcomes and substance use service provision.