Addressing Substance Abuse in Appalachia

The nation’s substance abuse crisis disproportionately impacts Appalachia, where in 2018 overdose mortality rates for people ages 25–54 was 43 percent higher in the Region than the rest of the country. Appalachians struggling with substance use disorder encounter additional barriers including transportation, housing, access to care, education, and steady employment. These challenges make it even harder for those in recovery to connect with long-term recovery solutions and reenter the workforce and community. Furthermore a compromised workforce can impede economic output. Using a multi-pronged approach – including the INvestments Supporting Partnerships In Recovery Ecosystems (INSPIRE) Initiative – ARC supports innovative efforts to establish community-based recovery ecosystems to save lives and strengthen the Region.

NORC Substance Abuse Map
The Appalachian Overdose Mapping Tool, developed by NORC at the University of Chicago and ARC can map overdose mortality rates against demographic data and other important economic indicators at the state and county level.

What ARC is Doing to Address Substance Abuse

The SUPPORT Act, passed by Congress in 2018, offered additional guidance to ARC for taking on the opioid epidemic throughout the Region. ARC is applying that guidance to regionally-focused solutions that help establish recovery ecosystems, which encourage communities to take a holistic view of the support services and training needed to maintain recovery and obtain employment. “Community-based Recovery Ecosystems support the difficult path from treatment into the workforce, and help make substance use disorder recovery sustainable,” Tim Thomas said. “We have heard time and again how work supports recovery.” In Fiscal Year 2020, Congress has appropriated $10 million for ARC to invest in pilot recovery-to-work initiatives across the Region.

INSPIRE Initiative

The INvestments Supporting Partnerships In Recovery Ecosystems (INSPIRE) Initiative is a $10 million initiative addressing the substance abuse crisis by creating or expanding a recovery ecosystem that will lead to workforce entry or re-entry. Successful projects will support the post-treatment to employment continuum, as well as initiatives designed to coordinate, or link, recovery services and training that support the recovery ecosystem.

Recovery-to-Work Listening Sessions

ARC held listening sessions in six states between December 2018–April 2019. These listening sessions focused on the impact that the substance abuse crisis is having on economic and workforce opportunities across the Region and the support services needed to help Appalachians in recovery obtain employment. The session findings are summarized in this report, identifying five common themes that ARC should consider when addressing the economic issues stemming from substance abuse.

Substance Abuse Listening Sessions Wordcloud
After holding six Recovery-to-Work listening session in Appalachian communities, these were the words used most by participants.

Substance Abuse Advisory Council

ARC formed the Substance Abuse Advisory Council—a volunteer advisory group of community leaders from a variety of Regional sectors—to offer additional guidance and recommendations for ARC’s recovery ecosystem support. The Council convened in May 2019 and presented their recommendations for supporting a robust recovery ecosystem to ARC in August 2019.

Recovery-Focused POWER Investments

In 2019, ARC invested over $9 million through the POWER Initiative to strengthen recovery efforts specifically in coal-impacted communities.

Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic

ARC partnered with the National Association of Counties (NACo) to offer tools and resources that equip local leaders in  the fight against substance abuse.

“Rides-to-Recovery” Seed Funding

ARC invested in a community-led rides-to-recovery pilot project in Huntington, West Virginia to address transportation challenges individuals in recovery often face in accessing treatment and other support services.

Investments in Action

Troublesome Creek Stringed Instruments

ARC’s grantee, The Appalachian Artisan Center, is operating the Troublesome Creek Stringed Instruments Company to develop skilled craftspeople capable of producing quality instruments leading to high level employment for those in recovery.
Men work on building guitars

Hindman, Kentucky

Additional Resources