Opioids Ravaged a Kentucky Town. Then Rehab Became Its Business, the main source of economic opportunity

Long article. read at the link below

Latasha Kidd completed an ARC treatment program in Louisa and now works in a local nursing home.Credit...Stacy Kranitz for The New York Times





Opioids Ravaged a Kentucky Town. Then Rehab Became Its Business.
In Louisa, an unbearable social crisis has become the main source of economic opportunity.


Jackson had never lived in a trailer before, or a small town. She was born in Louisville, the daughter of a man with schizophrenia who, in 1983, decapitated a 76-year-old woman. Jackson was 1 at the time. In 2010, at 27, she was in a car accident and was prescribed pain pills. Not long after that, she began using heroin. Over the next decade she went through nine rounds of addiction rehab. Each ended in relapse. Her most recent one came in 2022 after her son was sentenced to life in prison for murder; he was 21. In Louisville on Christmas Day she called a residential rehab company named Addiction Recovery Care, which has its headquarters in Louisa. So now she was here, in Appalachian coal country, in a trailer along Lick Creek, in a town a tiny fraction the size of her home city, working as a nursing assistant in a nearby nursing home, sharing a trailer with Latasha Kidd, a local woman 12 years her junior with a mountain accent, a fade and blood-orange bangs. “This is culture shock,” Jackson said. “I’m a city girl, and there’s not a lot of us around, and I’m like: Mama!”

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In eastern Kentucky, a region plagued by poverty and at the heart of the country’s opioid epidemic, the burden of addressing this treatment gap has mainly been taken up by addiction-rehab companies. Many stand more like community centers or churches than medical clinics, offering not just chemical but also spiritual and logistical services with the aim of helping people in addiction find employment and re-enter society. And in the two five-year periods between 2008 and 2017, eight of the 10 counties in America with the steepest decline in overdose mortality rates were in eastern Kentucky. The state now has more residential treatment beds per person than any other state in the country, and provisional data show that, in the 12 months ending on June 30 this year, the number of overdose deaths dropped by 20 percent over the previous 12-month period. Eastern Kentucky is one of the places where you’re most likely to die of a drug addiction but also the place where you’re most likely to receive treatment for it.

About half of the company’s 1,000 current employees in the state are in recovery from some kind of substance-use disorder, and one-third have gone through one of the company’s more than 30 residential-rehab programs themselves. ARC has formed relationships with several accredited colleges and trade schools and in 2023 received $130 million from Medicaid, making it the state’s largest provider of treatments for substance-use disorders; that year, ARC bought a psychiatric hospital in Russell, Ky., and began planning to open centers in Ohio and Virginia.

The company’s rapid growth may have helped draw the attention of the F.B.I., which in August made public an investigation into ARC for potential health-care fraud. In Louisa, there was skepticism about the company’s place in town, which turned on rumors of exploitation and brainwashing and greed. “It’s like ARC has taken over everything,” a resident told me once. “People joke that it’s a cult.” Around town, the company’s logo, a drawing of an ark, popped up on buildings and lawn signs and brick walls, often next to images of Noah Thompson, a young country singer from town who, in 2022, won “American Idol.” He had worked for ARC, in construction.


Jackson and Kidd, both of whom had criminal records, were among the first group of ARC graduates to complete their nursing-assistant training while in recovery, as part of a new collaboration between the company and a local nursing home. Their co-workers described them as the most beloved caretakers on staff, and neither had missed a day of work since starting there in July. David McKenzie Jr., the nursing home’s sandy-haired owner and administrator, was one of their biggest proponents. “They’re ready to run through walls,” he said. “I see tremendous effort, tremendous willpower, determination, grit. They have transformed my view.”



https://www.nytimes.com/2024/12/11/magazine/opioid-addiction-recovery-kentucky-louisa.html

In the 2010s, as the power utility moved away from coal energy, the area lost hundreds of mining jobs, and ARC began buying up abandoned buildings in town and turning them into businesses staffed in part by clients in recovery.Credit...Stacy Kranitz for The New York Times