Across the nation, communities are suffering from rampant opioid misuse and overdose rates, and the 420 counties in the Appalachian region of the eastern U.S. have been disproportionately impacted by this epidemic of addiction.

This report aims to strengthen the local response to the opioid epidemic in Appalachia by presenting an analysis of its impacts on the region, followed by recommendations for local action. These recommendations are discussed in five sections: (1) leadership, (2) prevention, (3) recovery, (4) rehabilitation for justice-involved individuals and (5) economic development. Each recommendation section includes one or more case studies featuring an Appalachian county.