Eastern Ky. towns fight to recover from opioid epidemic, with help from newcomers and recovering addicts, national author reports
By Sam Quinones
Republished from The Free Press
In early 2020, Mandi Fugate Sheffel, 42, opened a tiny bookstore in her hometown of Hazard. Everyone thought she was crazy.
Downtown Hazard was a forbidding place to start any business, much less a bookstore. Most coal mines that once supported the area had closed. Many brick buildings from Hazard’s heyday were gone, bequeathing a gap-toothed look to Main Street.
What’s more, Fugate Sheffel couldn’t afford a website or employees. She had never run a business before. And she had a complicated personal history to wrestle with.
But she loved to read—particularly contemporary Appalachian authors like Silas House, James Still and Gurney Norman, who told stories that felt real to her. She figured others in town were tired, like her, of driving two hours to Lexington to buy books.
So, on January 30, she opened Read Spotted Newt in a 250-square-foot space—the size of a small bedroom.
I met Fugate Sheffel last spring when I visited Hazard for the first time. I came to speak about my book, The Least of Us, about America’s drug-addiction epidemic. I had heard about the town, and had formed an image of it as the buckle on Eastern Kentucky’s opioid belt.
From Fugate Sheffel, though, I heard another story—one that I heard elsewhere in the Appalachian coalfield.
“When you don’t have industry, you’re having ecological disaster and a drug epidemic—you would think all those things would get us to a place where the town would be uninhabitable,” Fugate Sheffel told me. “But that’s not what I’m seeing at all. I’m seeing a lot of people rally.”
The loping hills of Eastern Kentucky are studded with scores of towns like Hazard—and nearby Prestonsburg and Pineville and Corbin—that, over the centuries, emerged in the valleys and along its rivers. By the early 20th century, coal dominated the region, with roughly 700,000 men and boys toiling in the mines of Kentucky and neighboring West Virginia.
In the 1990s, “as one declined and things got worse, the other increased and things got worse,” Les Stapleton, the mayor of Prestonsburg, pop. 4,000, 35 miles northeast of Hazard, told me about the correlation between jobs and drugs.
Larger forces over which locals had little or no control exacerbated things: the rise of natural gas for power plants, new environmental standards, our shifting political and cultural landscape.
By the early 2000s, the region had become the epicenter of the new opioid epidemic, which had its epicenter in Eastern Kentucky, West Virginia, and southwest Virginia.
Downtowns emptied out. Buildings were abandoned. Business startups seemed dominated by “pill mills”—clinics that prescribed huge quantities of prescription painkillers. In the little evangelical churches, they prayed for an end to “hillbilly heroin.”
The state cracked down on the pill mills, but by 2017, Perry County was the worst-hit county in the United States when it came to hospitalization for opiate addiction.
But then, weirdly and unexpectedly, at the same time that everything was falling apart, things started to get better—and that old world started, very tentatively, to build itself back up.
In the past few years, some 43 businesses have opened in Hazard, creating 171 new jobs, said Bailey Richards, the town’s coordinator of downtown development. That includes a toy store, a café, a women’s boutique, a quilt and apparel place, and a smoothie shop. A longtime restaurant just moved downtown.
The population, which declined for most of the latter half of the 20th century, now appears to be inching up. The growth was driven mostly by outsiders—new families, mostly from cities in Kentucky, in search of a better future, and immigrants, including health-care workers a nascent Latino community.
Shane Barton, the downtown-development coordinator at the University of Kentucky’s Community and Economic Development Initiative, went so far as to call Hazard “a hip destination for young people.”
It was hard to say why this was happening. Gradually, people were becoming more aware of the crisis of Appalachia and were doing things trying to help. Covid-19 pushed people to move out of the cities. And there were the recovering addicts; they weren’t expensive to hire if you needed a barista or someone to stock your shelves or paint your walls, and they were eager to work, to live.
In Hazard, about a quarter of the new jobs are held by recovering addicts. In Pineville, an hour and a half southwest of Hazard, one-third of new jobs are filled by people in recovery, said Jacob Roan, who oversees economic development in the Bell County seat.
“When somebody gets clean, they want to change the world, and have ideas of how to change the world,” Stephanie Callahan, a former addict and current business owner in Hazard, told me. “You do something just to prove you can do it.”
That’s what inspired Joey Jones—the can-do spirit.
Jones and his wife, Nikki, grew up in Hazard, went to the University of Louisville, and in 2019, returned home after ten years away, now with two kids.
Though a trained social worker, Joey Jones opened a toy store. This was last year. He called it Ready Set Play, and it’s on Main Street. Jones advertises on social media and, despite selling toys that are available online, he is expanding.
“The small business community here feels like family,” Jones said. Mandi Fugate Sheffel, who knew something about hard times and people coming together, agreed.
She had been in high school in the 1990s, as the mines were closing and pain pills were invading. “One day, we were drinking beer in the back of a truck,” she said. “Then, all of a sudden, these pills were everywhere.” By 1997, she was an OxyContin addict.
The addicts dubbed a local park “Pillville,” and Fugate Sheffel got out. She moved to western Kentucky, came home in 2002, got sober, married, had a son. She survived.
So did her bookstore, against all odds.
A few days after she opened it, in 2020, it was flooded. Then Covid hit and Kentucky’s governor banned in-store shopping, and Fugate Sheffel thought this might really be it for Read Spotted Newt.
But after news media reported on Read Spotted Newt’s woes, Fugate Sheffel started getting orders from all over. Soon, she said, “I was shipping books everywhere—Boston, Florida, Texas, L.A. Anybody who had any tie to Eastern Kentucky who knew this was going on were like, ‘We gotta make sure she makes this work.’”
By late 2020, she had moved to a larger space—a triangular building on a corner that once housed Hazard’s tourist welcome center. The city renovated it for her.
There are other pockets of hope scattered across the region.
In Prestonsburg, an hour north of Hazard, there are five locally owned restaurants, all but one of which opened in the last five years. An Indian restaurant is coming soon. The two-block historic downtown once had eleven abandoned buildings. Now, all are occupied.
In Pineville, pop. 1,600, the downtown was similarly decimated. Now there are boutiques, a hair salon, a furniture store, and several restaurants. Importantly, noted Roan, the economic-development director, “Those businesses are still in business six, seven years after opening.”
In Corbin, pop. 8,000), just up the Cumberland Gap Parkway from Pineville, several old buildings have been redone. They now house restaurants, a clothing boutique, a print shop, a café, an ice cream parlor, a record store, and a pinball museum.
“Everybody is like, ‘What can I start? What’s missing around here?’ ” Corbin Mayor Suzie Razmus told me.
Something else locals are starting to see in these places: people. On the street, outside their favorite coffee shop, chatting with a friend through an open car window.
In the past, a town grew from a big factory that employed hundreds or more people. But no one’s waiting any longer for factories or big-box stores—to say nothing of the mines or unions—to save them.
Now, he’s facing a problem he could never have anticipated: a shortage of affordable housing. This has been driven, he added, by outsiders who, since Covid, have been moving to Prestonsburg and other towns across the region.
Jeff Siegler, whose firm Revitalize, or Die advises small towns on rebuilding, said the area’s success “has to be about small, incremental victories—one business at a time.”
The new generation of mayors, town councilors, and city planners across much of Appalachia, who had come through the disaster of the last three decades and seemed inspired by recovering addicts in their own communities, understood what Siegler was saying: small is good; local is good; people are good.
Instead of trying to lure massive out-of-state companies with tax incentives, they were thinking about beautification projects and homeowners and places where people could congregate.
“That’s the shift,” said UK’s Shane Barton. “How can we make our communities people-ready as opposed to industry- or investment-ready?”
Still, progress is uneven, and many small-town economies are frail. Self-reliance may take them only so far.
The drug problem rages on. Fentanyl seems to be mixed into everything on the street, creating staggering numbers of overdoses. On top of all this, a form of perverse gentrification has taken hold that’s peculiar to this birthplace of the opioid epidemic. Legions of national drug treatment centers catering to the addicts have moved to the region—sopping up cheap real estate and pricing lower-income buyers and start-ups out of the market.
But at this point, that seems like a minor, mostly surmountable hurdle, at least to the people here who have stopped waiting for outsiders—coal companies, big-box retailers, Frankfort, Washington—to save them.
That is definitely the way Stephanie Callahan, in Hazard, sees things.
Now in her early forties, Callahan, like Mandi Fugate Sheffel, was part of the generation consumed by Oxycontin. She got clean when she had a baby—this was 15 years ago—and built a career as a showroom saleswoman at a local furniture company. But she yearned to do something on her own.
She loved fashion. For two years, she had been running a side hustle out of her bedroom, selling plus-size clothes. She hated that she had to go to Lexington every time she needed a new top or skirt.
So, in the summer of 2021, Callahan quit her full-time job and rented a space in downtown Hazard that had once been a gym. Her father said she’d lost her mind, opening a women’s clothing store during Covid. She did it anyway, calling it Hot Mess Express, which is what her mother and friends often called her.
She showed them: in her first two years, Callahan had 2,000 repeat customers. She now has nine part-time employees and will soon open a men’s store.
It wasn’t just about the clothes. It was about people in Hazard, like so many towns, trying to find their way back to each other.
“When I was growing up, we had arcades, movie theaters, mom-and-pop restaurants,” Callahan said. Now, “there’s no place for people to go talk to each other.”
So, she put a brown leather couch, almost as an afterthought, in the middle of the store, intending it for men accompanying their wives and girlfriends to sit and scroll through their phones or read a magazine—kill time. Instead, it became the focal point of the store, and it made Hot Mess Express a community hangout as well as a women’s boutique. A little place, or nook, where people would say hi, catch up, laugh, hug, gossip.
“It’s comfortable,” Callahan told me, referring to the couch. “I have a photo of the mayor asleep on it.”
Sam Quinones is the author of four books, including his latest, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. You can follow him on X at @samquinones7.
Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
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