Crisis in the Coalfields: State/Corporate Violence, Historical Trauma, & Concentrated Substance Misuse and Harm

What we frame as "the problem" in our society shapes our responses, which also shapes how and where we spend our resources. The prevailing narratives surrounding drug issues in rural coalfields, West Virginia, the Appalachian region, and arguably throughout the U.S. often mischaracterize the problem. This research explored the relationship between state/corporate violence, historical trauma, and concentrated substance misuse and harm in the rural, central Appalachian coalfields. This study employs a trauma-informed, critical ethnographic approach by utilizing participant observation and photo-elicitation interviewing to collect the data, and a critical qualitative framework to analyze it. The main findings of this research are as follows: historical trauma in the coalfields has been created and sustained by unchecked state and corporate violence within the region; (2) this violence and the historical trauma response has created a set and setting that influences individual experiences and is conducive to the level of substance misuse observed within the region; & (3) there are trauma-informed practices being implemented within the region but they are concentrated in metropolitan areas that are far away from the most-affected communities limiting the ability of these practices to account for the effects of historical trauma.