"The Hub is meeting people where they are, but not leaving them there, offering a comprehensive approach to substance use that saves lives and rebuilds communities."
In the heart of rural Eastern Kentucky, a region grappling with the enduring legacy of the opioid crisis, a vital network of community centers known as "The Hubs" is providing a beacon of hope and a lifeline for individuals and families affected by addiction. Funded by historic opioid settlement dollars, these multifaceted programs are demonstrating the profound impact of harm reduction strategies, offering a holistic suite of services that go beyond traditional recovery models to address the complex social and economic factors contributing to substance use disorders.
Jamie Madden’s story is a poignant illustration of the pervasive influence of drugs on life in this region. Her earliest memories are steeped in the reality of her father’s drug-related activities, shaping her understanding of how to provide for a family. By her teenage years, she was battling pain pill addiction, a struggle that escalated to methamphetamine by age 30, leading to the loss of custody of her children and periods of incarceration. At 40, facing another pregnancy, Madden sought a path to sobriety and discovered The Hub in her hometown of Whitesburg, a town of just 1,575 residents.
The Kentucky River District Health Department’s Hub initiative, a critical component of the state’s strategy to mitigate the consequences of drug misuse, has been instrumental in this transformation. Over the past two years, hundreds of thousands of dollars from opioid settlement funds have been channeled into Eastern Kentucky, supporting a network of community centers that offer a diverse range of services. These services span from peer support for recovery and access to essential resources like canned food to vital harm reduction tools such as sterile syringes.
The significance of this initiative is underscored by a recent announcement from Kentucky Attorney General Russell Coleman, who awarded $320,000 to The Hub initiative. This funding is expanding the program’s reach, establishing Hubs in four rural Eastern Kentucky counties – Knott, Lee, Letcher, and Owsley. These counties, recognized among the nation’s most impoverished, are now better equipped to address substance use disorders, alongside critical issues like housing instability, food insecurity, and unemployment. The innovative "Hub on Wheels" program further extends these services across the district, ensuring accessibility for even the most remote populations.
The impact of this investment is amplified by further funding. In 2025, The Hub received an additional $545,000 from the same settlement source, enabling an expansion from two to five counties, with a new Hub slated for Perry County. The recent $320,000 grant is specifically earmarked for a two-year program designed to support women transitioning back into society after incarceration. These grants are part of Kentucky’s substantial share of the $57.8 billion settlement reached with pharmaceutical companies, aimed at addressing the devastating opioid overdose crisis.
Madden unequivocally believes that investing in harm reduction services is a prudent and effective use of these funds, a conviction forged through her own journey of recovery facilitated by The Hub. Harm reduction, at its core, is about meeting individuals with substance use disorders where they are, without judgment, and providing the support and resources necessary to minimize immediate risks and foster a pathway toward long-term well-being.
Whitesburg, a town celebrated for its vibrant cultural scene, notably the Appalshop media, arts, and education center, embodies a fierce sense of community pride. The Hub’s presence on Main Street, nestled among local businesses and civic institutions, signifies its integration into the fabric of the town. The program’s philosophy, "Meeting you where you are but not leaving you there!", encapsulates its commitment to providing comprehensive support.
The inaugural Hub, established in Beattyville in 2022, exemplifies this model. It offers not only basic necessities like breakfast, lunch, and a food pantry, but also essential services such as a clothing closet, laundry facilities, and a computer lab. Crucially, it provides access to life-saving medications like naloxone, which can reverse opioid overdoses, along with drug test strips, hepatitis C treatment, sterile syringes, and wound care. This holistic approach recognizes that recovery is not solely about abstinence but also about addressing the immediate health and safety needs of individuals.
JoAnn Fraley, Kentucky River’s harm reduction program coordinator and Hub initiative director, articulates the program’s foundational understanding: "In order for anybody to sustain recovery, they have to have financial stability, they have to have transportation, and they have to have a home. We try to fill those gaps." This philosophy acknowledges that addressing the root causes of vulnerability is paramount to successful and lasting recovery.
While some critics question the efficacy of syringe exchange programs, suggesting they may inadvertently encourage drug use, a wealth of research refutes these claims. Studies published in journals like the "Journal of Substance Use and Addiction Treatment" consistently demonstrate that participants in syringe services programs are more likely to reduce their injection drug use, cease drug use altogether, and engage with and remain in treatment. Furthermore, the Centers for Disease Control and Prevention (CDC) reports that these programs can reduce the transmission of HIV and hepatitis C by approximately 50 percent, highlighting their significant public health impact.
The effectiveness of The Hub model has garnered national recognition. In 2025, the Kentucky River’s Hub model was honored as one of 19 "Model of Promising Practice" award winners by the National Association of County and City Health Officials, a testament to its innovative and impactful approach to public health.
Lauren Carr, an advisor for the Kentucky Association of Counties on the utilization of opioid settlement funds, emphasizes the community-centered nature of The Hub. "What jazzes me about it is it’s a community approach to harm reduction," Carr states. "Whether that’s feeding a hungry stomach, or putting clothes on somebody’s back, or giving them clean [syringes], you’re meeting that person’s needs. It can be that lifeline."
The personal stories of transformation within The Hub network are profoundly inspiring. Becky Todd, a community health worker and peer support specialist leading the Beattyville Hub team, shared her journey of recovery after being released from jail on drug-related charges. With nowhere else to turn, she walked three miles to The Hub and found the support she needed to pursue her bachelor’s degree in social work. "I could not have done it without this place. It’s my saving grace," Todd declared.
Amber McDaniel, who found solace at The Hub after more than a decade of addiction, losing her home, children, and family support, echoed this sentiment. "I didn’t know where to turn, didn’t know what to do. I mean, I was about to lose my mind," she recalled. McDaniel is now a valued member of The Hub’s staff through AmeriCorps.
Hannah Stamper, who began using methamphetamine at 14 after being placed in foster care, found a new purpose at The Hub. Driven by a past desire to be needed, she now serves on staff through Recovery Corps, a program that trains AmeriCorps members for the recovery field. "People today need me in a good way, and I love that," Stamper expressed, highlighting the transformative power of channeling past motivations into positive community engagement.
The impact of The Hubs extends beyond individual recovery, fostering a palpable shift in community attitudes. Fraley has observed a significant change in Lee County, where conversations about addiction and homelessness were once fraught with discomfort and avoidance. "The community sees The Hub’s impact, and now they’re, like, ‘Whoa. We love you.’" she noted, indicating a growing acceptance and appreciation for the vital work being done.
Scott Lockard, the district’s public health director, points to a combination of data and anecdotal evidence that substantiates the initiative’s success, including an uptick in individuals entering treatment and a decrease in reported communicable diseases. "I’ve been in public health for 36 years, and it’s one of the most effective interventions I’ve seen," Lockard affirmed.
The Kentucky River team’s commitment to community engagement and education has been key to overcoming potential resistance to harm reduction strategies. Fraley emphasized that the planning process has consistently involved individuals with lived experience of addiction, ensuring that their voices are central to the decision-making. "Their voice needs to be at every table," she asserted.
Lockard further stresses the importance of community involvement in ensuring the wise allocation of resources. "We’ll talk to those people who are experiencing the problem, find out what they think would help them best, and then look for those evidence-based interventions," he explained.
This collaborative approach is evident in activities like the crafting classes held at the Whitesburg Hub, attended by individuals in recovery such as Jannie Gatlin and Mandy Parker. Gatlin, who began using fentanyl in Colorado after the death of her infant son, now attends the Hub almost daily with her toddler, Hunter. Parker, who turned to street drugs after her prescribed opioid medication for a kidney disorder became less accessible, believes The Hub is instrumental in dismantling the stigma surrounding substance use disorder. "That’s just the nature of the beast," she said, reflecting on the cycle of addiction. "When people see ‘real change happening,’ there’s a ripple effect. It makes a difference."
Parker’s appreciation for The Hub’s central location on Main Street underscores its integration into the community and its accessibility to those who need it most. The Hubs in Eastern Kentucky are not merely service providers; they are vibrant community anchors, fostering hope, healing, and a renewed sense of possibility in a region profoundly impacted by the opioid crisis.
