Wednesday, April 12, 2023

Response to 'Why Appalachia’s Substance Use Problems Have Systemic Roots' (published 4-12-2023; article #402)

7/10/2015 photograph, by Zack Spear on Unsplash. Free to use under the Unsplash License.


Greetings, to each international, national, regional, and local reader -- especially to you, dear reader. My hope, in the Lord, is that you are well. By the Gregorian calendar, Good Friday and Resurrection Sunday (Easter) have passed. Иисус воскрес! Воистину, Он воскрес! My brother, next in age to me, attained age 60, on Resurrection Sunday. We enjoyed a good phone conversation. His family and he are doing well enough, thankfully.

On Monday, family remembered my mother-in-law, Phyllis Ann House Gordon (4/10/1941 - 4/30/2017). Mrs. Appalachian Irishman, my father-in-law, her sister, and I disassembled my sister-in-law's bathroom sink faucet. The new faucet assembly required new water line, which we didn't have. That “work in progress” completed today. My mother-in-law would have enjoyed the “fun” on her birthday. The effort, to help my sister-in-law, honored my mother-in-law, whom I look forward to seeing again, where she is now, with the Lord.

This twenty-fourth article, on Appalachia - Upper East TN, is my response to the article of 2/16/2023, on Appalachian History. The excellent website “has been digging up stories, quotes and anecdotes about the region since 2006 . . . with an emphasis on the 1880s - 1950s.” The articles, about one a month, are usually informative, historical, and entertaining. For example, the article, of 4/4/2023, shares an excerpt from an author's book, which is quite interesting! Apparently, a man, thought to have been dead, was not. This article, by no means, critiques the body of work on Appalachian History!

The guest article, of 2/16/2023, however, had raised my Irish dander, when I read it, initially, in late February. I happened to notice it again, while reading the excellent article of 4/4/2023. My Irish dander arose again! This article is how I speak my mind. The conclusion will explain the true source of and solution to problems -- in Appalachia, Oregon, this once great nation, and the world in general.

The 2/16/2023 Article

The guest article that rekindled my Irish dander today is: “Why Appalachia’s Substance Use Problems Have Systemic Roots,” on Appalachian History, written by Amanda Winstead, published by Dave Tabler, 2/16/2023. The guest writer, as Dave Tabler notes, in his introduction to her, is from Portland, Oregon.

The guest article, of over a thousand words, has five sections: an introduction, “Poverty and the 'Diseases of Despair,'” “The Economics of Addiction,” “The Legacy of Big Tobacco,” and “The Takeaway” (or conclusion). First, I summarize those sections. Then, I state my response and conclusion.

The Introductory Remarks

Properly, the introductory remarks compliment the beauty of the Appalachian region, disapprove of the stereotype of the region's inhabitants, and state, “Appalachian peoples are not more 'prone' to addiction than any other regional, cultural, ethnic, or socioeconomic demographic.”

The final paragraph, of the introductory remarks, states the theme of the article:

Addiction in the region has deep, complex, and multigenerational roots. It is a systemic plague that will only be addressed through comprehensive interventions.

Three sections continue the theme. They are as follows.

Poverty and the “Diseases of Despair”

The point, in this section, is that poverty in Appalachia is a root cause “to a lack of access to quality health care,” “uninsured and underinsured” folks, “a dearth of healthcare providers” -- especially “mental health care” and “addiction recovery services.”

Apparently, Appalachia suffers from “diseases of despair” (which links to a 5/31/2021 Forbes article). This is explained as “excessive rates of suicide” and “significantly higher risks for substance use disorders.”

This section embeds links to four other websites, three of which are not noteworthy. One, however, is to the Appalachian Regional Commission (ARC), which proclaims itself to be “an economic development partnership agency of the federal government and 13 state governments focusing on 423 counties across the Appalachian Region.” Its mission is “to innovate, partner, and invest to build community capacity and strengthen economic growth in Appalachia.” (Interestingly, the guest writer's notation of poverty in Appalachia does not indicate that the ARC has been doing very well in its mission.)

The section's concluding statement is that a “generational cycle” “continues even when the original catalyst (poverty, lack of healthcare access, etc.) ends.”[C]hildren grow up in a home with substance-abusing grandparents, parents, or siblings. A family legacy of dependency is born.”

The Economics of Addiction

This second section, apparently, attempts to indicate that the economy of Appalachia contributes to alcohol, drug, and especially opioid addiction in the region. It begins by stating:

Farming, especially tobacco farming, and coal mining have long been the principal industries, and one of the few sources of stable work, in the region for generations.

The guest writer theorizes that injuries and illnesses from those dangerous jobs have “been egregiously exploited by the pharmaceutical industry” (or “Big Pharma” as the article states). The exploitation by “Big Pharma,” as the article speculates, caused the “opioid epidemic,” which may have originated in Appalachia.

The Legacy of Big Tobacco

In the third section, the guest writer speculates that tobacco farming “has given rise to generations of smokers and snuff users. From chewing tobacco to cigarettes, tobacco products remain ubiquitous in many parts of Appalachia.”

The section ends with comments on how folks have been turning to e-cigarettes and “vaping” those e-cigarettes. Apparently, according to the guest writer, the government's efforts to control e-cigarettes are driving folks in the region to buy them on the black market.

The Takeaway

The guest writer concludes her article, in one paragraph, by stating:

The story of addiction in Appalachia is far more complex than the stereotype acknowledges. It is a pervasive disorder with deep, systemic roots. It is a pandemic that will only end when, as a nation, we confront the economic, political, medical, and cultural catalysts driving it.

My Response

What is my response? In general, after my Irish dander cooled enough, the guest writer appears to stereotype Appalachia, in a manner similar to the stereotyping done by others, whom she criticizes correctly. I, however, don't think that she realized that she was doing so.

First, was the guest writer born and raised in Appalachia, before moving to Portland? I doubt it. If not, then why, pray tell, did she write a guest article on Appalachia?

Having never been to Portland, Oregon, or even to Oregon, I could write an article titled “Why Oregon's Substance Use Problems Have Systemic Roots.” Unlike the guest writer, however, I am not that impudent. I did search by that potential article title. I discovered and downloaded the “2020-2025 Oregon Statewide Srategic Plan,” by the Alcohol and Drug Policy Commission, on Oregon's state government website.

I suggest that the guest writer publish future articles about her “back yard,” not mine. The “2020-2025 Oregon Statewide Strategic Plan,” by my quick glance, shows that Oregon has systemic substance abuse problems -- just as Appalachia does. I am not so impertinent as to publish an article about her “back yard,” while I stay in mine!

Second, the logic of the guest writer argues, incorrectly, that “poverty, lack of healthcare access, etc.” lead to “substance-abusing grandparents, parents, or siblings” that creates a “legacy of dependency.” The writer has committed the logical fallacy of causation, by assuming that the former leads to the latter, without sufficient proof. Correlation does not imply causation.

For example, Mom and Dad raised us four boys on soup beans and taters. As the oldest, I passed down clothes to younger brothers. Doctor Goforth, other doctors, the hospital in town, and hospitals in nearby cities were available. Dad could afford health insurance for us, until the cost became too high to afford. My maternal and paternal grandparents were by no means wealthy. The guest writer, to hear my story, would say that I was raised in poverty or near poverty. Dad was a water well driller. Mom left her job at the telephone company, to raise us boys. We raised garden. We survived well enough.

The “economically challenging” environment of my grandparents, parents, and siblings, however, did not lead to substance abuse! Again, correlation does not imply causation. We, instead, relied on the Bread of Life to sustain us, which He did. Poverty does not, inherently, cause substance abuse.

Third, the guest writer must have gone back in time. Farming, tobacco farming, and coal mining are certainly legacies of Appalachia. They, however, are not -- and have not been for decades -- “principal industries” and “the few sources of stable work” in the region.

The old tobacco warehouses are mostly gone -- replaced by businesses. Farm land has become subdivisions, industrial parks, and office complexes. The Appalachia in the writer's mind existed decades ago. Folks still farm and raise tobacco, often on the side.

My area of Appalachia did not and does not have any noticeable number of coal mines. Apparently, there are no coal mines in Tennessee. For example, U.S. Energy Information Administration (EIA), Tennessee, Profile Analysis, Coal (last update, 8/18/2022) reports, “. . . the state no longer produces coal. The state's few mines last produced coal in early 2020.”

Fourth, it appears that the guest writer was running out of vapor, by writing about vaping, near the end of her article. Dad smoked, until he decided to quit. I tried cigarettes, in high school. Dad caught me, bought me a pack of cigarettes and a lighter. He said, “I can't tell you not to smoke, son, since I do, but don't hide it.” Dad's eight-grade-educated psychology worked! I never bothered to smoke again! I wonder if folks in Oregon have ever smoked, chewed tobacco, or smoked e-cigarettes.

Finally, the author's “The Takeaway,” or conclusion, offers no solution as to how we, as a nation, can improve the “catalysts,” which are stated. (As an interesting note, the author describes the “story of addiction in Appalachia” as a “pandemic.” I thought that a pandemic was global. Appalachia is a region on the globe.) Don't worry! My conclusion will offer the solution!


The solution to systemic substance abuse -- in Appalachia, Oregon, this once great nation, or the world -- is not found in the United Nations, the federal government, any state government, or any government partnership agency (e.g., the Appalachian Regional Commission). What is my solution?

My solution patterns the inspired apostle Paul. In his first century letter to the church at Ephesus, he wrote (with my emboldening added for emphasis):

Do not get drunk on wine, which leads to debauchery. Instead, be filled with the Spirit, speaking to one another with psalms, hymns, and songs from the Spirit. Sing and make music from your heart to the Lord, always giving thanks to God the Father for everything, in the name of our Lord Jesus Christ. (Eph. 5:18-20, NIV)

The reading of the entire letter to the Ephesians is encouraged. Ephesians 5:18-20 is a section in the apostle Paul's theme “to live a life worthy of the calling you have received” (Eph. 4:1, NIV), which continues to Ephesians 6:20. The theme to live worthy of Christ's calling follows the apostle's eloquent statements of God's grace, in chapters 1-3. This is an inspired statement of causation.

The solution is to be filled with the Spirit of God -- not wine, alcohol, drugs, or any form of immorality. My parents, maternal grandparents, and paternal grandparents were filled with God's Spirit, as their godly lives demonstrated. Despite impoverished or near impoverished conditions – with hard manual labor and limitations on health care and insurance -- my ancestors did not succumb to substance abuse -- since they filled themselves with the Spirit of God. This is my family legacy of faith, in Appalachia.

This article is also my ninety-second on heritage and is written in honor of my paternal grandfather, Marion Ferrell (4/13/1880 - 11/21/1970). Tomorrow will mark the date of his birth, in 1880.

The systemic solution is spiritual. “Dear Lord, as my written prayer, thank you for your grace, the faith of my ancestors, and your gift of grace to me, through Christ Jesus. May all people, in Appalachia, Oregon, this nation, and the world, in free will, accept your everlasting solution of salvation, which frees us from the systemic evils that plague humankind. In Christ's name, I pray. Amen.”

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