WHITESBURG, Ky. — Drugs and the results of habit are woven into the material of Jamie Madden’s life.
Her earliest reminiscence is of standing on the passenger seat of her dad’s automobile as a toddler, carrying a peach-colored shirt, whereas he drove from their Kentucky house to Florida to choose up medicine. On a cease for a burger, she met Ronald McDonald.
“I grew up with the impression that that’s how you paid your bills,” Madden stated. “That’s how your kids got things.”
By 16, she was hooked on ache capsules. By 30, methamphetamine. She misplaced custody of two youngsters and gave up two extra for adoption at beginning. She served time within the county jail and state jail.
Pregnant once more at 40, Madden resolved to cease utilizing. It was then that she realized of The Hub in Whitesburg, a city of 1,575 residents, her hometown.
Over the previous two years, the state of Kentucky has despatched a whole lot of hundreds of opioid settlement {dollars} to the agricultural japanese area of the state to assist decrease the ramifications of drug misuse. The Hub, a program that oversees a community of neighborhood facilities providing a variety of providers from restoration peer help to canned meals to sterile syringes, is a part of that effort.
In April, Kentucky Attorney General Russell Coleman introduced $320,000 could be awarded to the Kentucky River District Health Department’s Hub initiative. There at the moment are Hubs in 4 rural japanese Kentucky counties — Knott, Lee, Letcher, and Owsley, all of that are among the many nation’s most impoverished — addressing substance use issues, housing, starvation, employment, and different challenges. The program additionally operates The Hub on Wheels, which gives providers all through the district.
In 2025, The Hub acquired $545,000 from the identical supply, facilitating enlargement from two to 5 counties. (The fifth Hub shall be in Perry County.) The new $320,000 is a two-year grant to develop a program to assist ladies who’ve been incarcerated reintegrate into society.
Both grants are from Kentucky’s roughly $1 billion share of the $57.8 billion for state and native governments from the settlement reached with pharmaceutical companies to resolve litigation for his or her function in fueling the opioid overdose disaster.
Madden believes funding in hurt discount providers is cash properly spent. She’s witnessed them work in her personal life. She’s discovered stable footing for restoration at The Hub.
The Hub is based on the rules of hurt discount. Support consists of housing, meals, healthcare, and overdose prevention instruments. (Taylor Sisk for KFF Health News)
But the Trump administration is reducing federal funding for such efforts, disputing their advantages. A July 24 executive order instructed packages throughout the nation that they might not anticipate federal funding. The order stipulated that discretionary grants issued by the Substance Abuse and Mental Health Services Administration shouldn’t be spent on “so-called ‘harm reduction’” efforts, claiming they “only facilitate illegal drug use and its attendant harm.”
Advocates for these providers on this rural area, which solid its ballots for President Donald Trump in all three elections, beg to vary.
Meeting Folks Where They Live
Whitesburg — house to a full of life cultural scene, together with Appalshop, a media, arts, and education center — is a city residents are fiercely proud to name house. The Hub is housed in a storefront on Main Street, neighboring City Hall, Hazard Coffee Company, Cut-Away Barber & Beauty Shop, and the fireplace station. Like the opposite Hubs, it gives a variety of providers focused to the wants of the neighborhood.
The inaugural Hub, launched in 2022 in Beattyville, the Lee County seat, two hours northwest of Whitesburg, provides breakfast and lunch, a meals pantry, a clothes closet, a laundry room, and a pc lab. Also: naloxone, a drugs that may rapidly reverse an opioid overdose; drug take a look at strips; hepatitis C therapy; sterile syringes; and wound care.
The program’s motto is “Meeting you where you are but not leaving you there!” It’s based on the rules of harm reduction. Harm discount providers are designed to attenuate the consequences of drug use, maintain individuals protected, and deal with them with respect, till they is likely to be able to enter restoration. The help consists of housing, meals, healthcare, and overdose prevention instruments.
JoAnn Fraley is Kentucky River’s hurt discount program coordinator and its Hub initiative director. “In order for anybody to sustain recovery, they have to have financial stability, they have to have transportation, and they have to have a home,” she stated. “We try to fill those gaps.”
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While critics counsel that exchanging clear syringes for used ones abets drug use, analysis printed within the Journal of Substance Use and Addiction Treatment signifies that individuals who take part in syringe providers packages are extra possible than those that don’t to reduce their injection-drug use or cease utilizing medicine altogether, and that they’re extra more likely to enter and stay in therapy. According to the Centers for Disease Control and Prevention, syringe providers packages additionally reduce the spread of HIV and hepatitis C by about half.
In 2025, Kentucky River’s Hub mannequin was named certainly one of 19 public health best practices award winners by the National Association of County and City Health Officials.
“What jazzes me about it is it’s a community approach to harm reduction,” stated Lauren Carr, who advises the Kentucky Association of Counties on how finest to make the most of opioid settlement funds. “Whether that’s feeding a hungry stomach, or putting clothes on somebody’s back, or giving them clean [syringes], you’re meeting that person’s needs.”
“It can be that lifeline,” Carr stated.
Paying Back for Good
Becky Todd, who leads the Beattyville Hub’s staff, is a neighborhood well being employee and peer help specialist. In April 2024, she was launched from jail, having served a number of sentences on drug-related costs. She walked 3 miles from jail to The Hub with nowhere else to go. She’s working towards her bachelor’s diploma in social work at Eastern Kentucky University.
“I could not have done it without this place,” Todd stated. “It’s my saving grace.”
Amber McDaniel remembers the primary time she entered The Hub, after greater than a decade of habit, having misplaced her house, her children, and her household’s help. “I didn’t know where to turn, didn’t know what to do,” she stated. “I mean, I was about to lose my mind.” She’s now a Hub employees member through AmeriCorps.
Hannah Stamper was positioned in foster care and commenced utilizing meth at 14. She was drawn to dealing medicine as a result of “I loved for people to need me.” She’s now on employees as a member of Recovery Corps, a program that trains AmeriCorps members to work within the restoration subject. “People today need me in a good way, and I love that.”
Hannah Stamper is a employees member of The Hub in Beattyville, Kentucky, by means of Recovery Corps, a program that trains AmeriCorps members to work within the restoration subject. (Taylor Sisk for KFF Health News)
Fraley has witnessed a transition in Lee County. A half-dozen years in the past, conversations in public conferences about habit and homelessness have been strained “because nobody wanted to talk about it or acknowledge it.”
The neighborhood sees The Hub’s impression, she stated, “and now they’re, like, ‘Whoa. We love you.’”
Scott Lockard, the district’s public well being director, stated a mixture of knowledge and anecdotal observations substantiates the initiative’s success, together with a rise within the variety of individuals getting into therapy and a decline in reported communicable ailments.
“I’ve been in public health for 36 years, and it’s one of the most effective interventions I’ve seen,” Lockard stated.
The Kentucky River staff labored to teach the neighborhood in regards to the potential outcomes of the Hub mannequin, and Fraley stated there was little resistance, simply concern that the cash be properly spent. She stated the planning has at all times included individuals who have lived with habit.
“Their voice needs to be at every table,” she stated.
Jannie Gatlin, who’s in restoration, involves The Hub in Whitesburg, Kentucky, virtually each day together with her son, Hunter. (Taylor Sisk for KFF Health News)
Lockard agrees. To make sure the neighborhood is investing this cash properly, he stated, “we’ll talk to those people who are experiencing the problem, find out what they think would help them best, and then look for those evidence-based interventions.”
Jannie Gatlin and Mandy Parker, who each are in restoration, attended a latest crafting class on the Whitesburg Hub. Gatlin, who began taking fentanyl in Colorado after her first son died at 2 months outdated of a digestive dysfunction, comes virtually each day together with her toddler, Hunter.
Parker was prescribed opioids for ache from a kidney dysfunction. When these capsules grew to become much less accessible, she turned to avenue medicine. “That’s just the nature of the beast,” she stated.
She believes The Hub helps break the stigma of substance use dysfunction in her neighborhood. When individuals see “real change happening,” she stated, there’s a ripple impact. “It makes a difference.”
She appreciates that The Hub is right here on Main Street — proper, she firmly believes, the place it must be.
