State-Corporate Violence, to Historical Trauma, to Concentrated Substance Misuse in the southern West Virginia coalfields

• In Event: Critical Issues in Historical and Transnational Contexts

Abstract

West Virginia has the highest drug overdose mortality rate in the United States, with the crisis disproportionately affecting the southernmost regions of the state, particularly the rural coalfields. While mainstream narratives often frame this as a "drug problem," such characterizations fail to account for the broader historical and structural forces at play. This analysis argues that substance misuse and overdose in central Appalachia are not merely individual or community failings but are deeply rooted in a legacy of state and corporate violence. By examining the historical trauma inflicted upon coalfield communities—through state violence, exploitative labor practices, environmental devastation, economic disinvestment, and systemic neglect—this study draws connections between past injustices and present-day public health crises. This historical framework challenges conventional perspectives and calls for a more nuanced understanding of concentrated substance misuse and overdose within Appalachia. In doing so, this research highlights the urgent need for policies that address the root causes of substance use disorder, including economic revitalization, healthcare access, and community-led interventions.

Author

• Brooke Baker, Marymount University