The Atlantic

The Pharmacies Thriving in Kentucky's Opioid-Stricken Towns

In a year, one county filled enough prescriptions for 150 doses of painkillers per resident.
Source: Phil Galewitz / Kaiser Health News

MANCHESTER, Ky.—This economically depressed city in the foothills of the Appalachian Mountains is an image of frozen-in-time decline: empty storefronts with faded facades, sagging power lines, and aged streets with few stoplights.

But there is one type of business that seems to thrive: pharmacies.

Eleven drug stores, mostly independents, are scattered about a tiny city of 1,500 people. Many have opened in the past decade—four in the past three years. And prescription pain drugs are one of the best-selling items—the very best seller at some.

Most pharmacies here and in surrounding Clay County (population 21,000) lack the convenience-store trappings of national chains like CVS or Walgreen’s. They sell few items over the counter, focusing on prescriptions and little else.

Clay’s residents filled prescriptions for 2.2 million doses of hydrocodone and about 617,000 doses of oxycodone in

You’re reading a preview, subscribe to read more.

More from The Atlantic

The Atlantic5 min readSocial History
The Pro-life Movement’s Not-So-Secret Plan for Trump
Sign up for The Decision, a newsletter featuring our 2024 election coverage. Donald Trump has made no secret of the fact that he regards his party’s position on reproductive rights as a political liability. He blamed the “abortion issue” for his part
The Atlantic6 min read
The Happy Way to Drop Your Grievances
Want to stay current with Arthur’s writing? Sign up to get an email every time a new column comes out. In 15th-century Germany, there was an expression for a chronic complainer: Greiner, Zanner, which can be translated as “whiner-grumbler.” It was no
The Atlantic5 min readAmerican Government
What Nikki Haley Is Trying to Prove
This is an edition of The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here. Nikki Haley faces terrible odds in her home state of

Related Books & Audiobooks