Mining, loss, and despair: Exploring energy transitions and opioid use in an Appalachian coal community

Abstract

The opioid epidemic has ravaged the United States, resulting in the highest number of opioid-related overdose deaths on record in 2020–2021. This phenomenon, often associated with “deaths of despair”, has acutely impacted Central Appalachia. Despite rapidly evolving literature on deaths of despair, limited research has been conducted to evaluate how coal mining and energy transitions relate to opioid use. We address this gap through a case study in Logan County, West Virginia, a region heavily impacted by the opioid epidemic with a strong history of coal mining. In 2021, Logan County was the fourth largest coal producing county in the state and first in opioid-related mortality rate. We conducted 14 semi-structured key stakeholder interviews in late 2019 to better embed deaths of despair in Logan County within the broader economic, cultural, and social realities of a rural coal mining community. We identified two key themes to explain the coal-energy transition-opioid nexus relationship: “ripple effects and despair” and “barriers to treatment and harm reduction resources.” These themes explore the connections between coal decline, broader economic distress, and increasing opioid use, as well as the sociopolitical challenge of expanding mental health and substance abuse services. Our results identify a major gap in energy transition scholarship and policy, namely, the need for further investigation into how the pursuit of low carbon energy transitions may negatively impact health and economic well-being in extractive fossil fuel landscapes. Low carbon energy transitions cannot be just without attending to these dimensions.