"We’re meeting people where they are, but not leaving them there." This philosophy guides The Hub, a network of community centers in rural Eastern Kentucky providing comprehensive support—from basic needs like food and housing to crucial harm reduction services—as a vital response to the persistent opioid crisis and its devastating consequences.
In the heart of Eastern Kentucky, a region historically grappling with economic hardship and the pervasive impact of the opioid crisis, a beacon of hope has emerged in the form of "The Hub." This innovative initiative, funded by opioid settlement dollars, is redefining community support by offering a multi-faceted approach to substance use disorders and the myriad challenges that accompany them. While lauded for its success in empowering individuals like Jamie Madden toward recovery, The Hub now faces an uncertain future due to potential federal funding cuts, prompting concern among advocates and the communities it serves.
Jamie Madden’s story is a poignant illustration of the deep-rooted struggles that The Hub aims to address. Her earliest memories are inextricably linked to the drug trade, a reality that shaped her upbringing in rural Kentucky. "I grew up with the impression that that’s how you paid your bills," Madden recounted, a stark testament to the generational cycles of addiction. By her teenage years, she was dependent on pain pills, a path that escalated to methamphetamine by age 30. The ensuing years were marked by profound loss: the separation from her children, incarceration, and a relentless battle against addiction. It was at 40, pregnant and determined to change her life, that Madden discovered The Hub in her hometown of Whitesburg, a town of just 1,575 residents.
The Hub is a direct beneficiary of the substantial opioid settlement funds allocated to Kentucky, aiming to mitigate the devastating repercussions of drug misuse across the state’s rural eastern counties. These funds, totaling hundreds of thousands of dollars, are channeled through initiatives like The Hub, which coordinates a network of community centers offering a diverse array of services. These services range from peer support for those in recovery to essential resources such as food pantries and sterile syringe exchange programs, all designed to meet individuals at their point of need.
In April, Kentucky Attorney General Russell Coleman announced a significant award of $320,000 to the Kentucky River District Health Department’s Hub initiative. This funding has facilitated the expansion of Hubs into four rural eastern Kentucky counties: Knott, Lee, Letcher, and Owsley. These counties are notably among the nation’s most impoverished, underscoring the critical need for the comprehensive support The Hub provides. The program addresses not only substance use disorders but also crucial social determinants of health, including housing instability, food insecurity, and employment challenges. Furthermore, the innovative "Hub on Wheels" program extends these vital services to remote areas throughout the district via a mobile unit.
The initiative’s growth trajectory is further evidenced by an additional $545,000 in funding received in 2025 from the same settlement source. This investment enabled The Hub to expand its reach from two to five counties, with a new center slated for Perry County. The recent $320,000 grant is specifically earmarked for a two-year program focused on assisting women reintegrating into society after incarceration, highlighting a targeted approach to a particularly vulnerable population. Both grants originate from Kentucky’s substantial share—approximately $1 billion—of the $57.8 billion national settlement with pharmaceutical companies held accountable for their role in fueling the opioid overdose crisis.
Madden, now a beneficiary of these harm reduction services, firmly believes that investing in such programs is a prudent allocation of resources. She has personally experienced the transformative power of The Hub, finding a stable foundation for her recovery within its supportive environment. However, this progress is shadowed by the potential impact of federal funding shifts. The Trump administration’s recent actions, particularly a July 24 executive order, have cast a pall over harm reduction efforts nationwide. The order stipulated that discretionary grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) should no longer fund "so-called ‘harm reduction’" initiatives, with the administration asserting that these programs "only facilitate illegal drug use and its attendant harm." This stance has generated significant concern among advocates and service providers in regions like Eastern Kentucky, areas that, despite often voting for President Trump, stand to lose critical support.
Meeting Folks Where They Live
Whitesburg, a town celebrated for its vibrant cultural landscape, including the renowned Appalshop media, arts, and education center, is a place its residents hold in high regard. The Hub’s physical presence on Main Street, nestled amongst local businesses and public services, symbolizes its integration into the community fabric. Like its sister centers, the Whitesburg Hub offers a spectrum of services tailored to the unique needs of its residents.
The inaugural Hub, established in 2022 in Beattyville, the seat of Lee County, provides a comprehensive suite of resources. This includes daily meals, a food pantry, a clothing closet, laundry facilities, and a computer lab. Crucially, it also offers life-saving medications like naloxone, which can reverse opioid overdoses, alongside drug test strips, hepatitis C treatment, sterile syringes for safer injection practices, and wound care services.
The program’s guiding principle, "Meeting you where you are but not leaving you there!", encapsulates its commitment to harm reduction. Harm reduction strategies prioritize minimizing the negative consequences of drug use, ensuring safety, and treating individuals with dignity and respect, with the ultimate goal of fostering an environment conducive to eventual recovery. The support provided encompasses fundamental necessities such as housing assistance, food security, healthcare access, and essential overdose prevention tools.
JoAnn Fraley, the harm reduction program coordinator and Hub initiative director for Kentucky River, emphasizes the interconnectedness of recovery and basic needs. "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," she stated. "We try to fill those gaps."
Despite criticisms that syringe exchange programs might inadvertently encourage drug use, a wealth of research, including studies published in the Journal of Substance Use and Addiction Treatment, demonstrates the opposite. These studies indicate that participants in syringe services programs are more likely to reduce or cease their injection drug use and are more inclined to enter and remain in treatment. The Centers for Disease Control and Prevention (CDC) further supports the efficacy of these programs, reporting that they can reduce the transmission of HIV and hepatitis C by approximately half. In recognition of its impactful model, Kentucky River’s Hub initiative was named one of 19 public health best practices award winners in 2025 by the National Association of County and City Health Officials.
Lauren Carr, who advises the Kentucky Association of Counties on the strategic utilization of opioid settlement funds, highlights the program’s community-centered approach. "What jazzes me about it is it’s a community approach to harm reduction," Carr remarked. "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." She underscores its role as a potential "lifeline" for individuals facing immense challenges.
Paying Back for Good
The success stories emanating from The Hub are numerous, featuring individuals who have transformed their lives through its comprehensive support. Becky Todd, the team lead for the Beattyville Hub, embodies this transformation. A community health worker and peer support specialist, Todd was released from jail in April 2024 after serving multiple sentences for drug-related offenses. With nowhere else to turn, she walked three miles to The Hub and has since been working towards her bachelor’s degree in social work at Eastern Kentucky University. "I could not have done it without this place," Todd shared. "It’s my saving grace."
Amber McDaniel found solace at The Hub after more than a decade of addiction, a period that saw her lose her home, her children, and her family’s support. "I didn’t know where to turn, didn’t know what to do," McDaniel recalled, her voice reflecting the desperation of her past. "I mean, I was about to lose my mind." Today, she is a valued member of The Hub’s staff, employed through AmeriCorps.
Hannah Stamper, who entered foster care and began using methamphetamine at age 14, found herself drawn to dealing drugs, seeking the validation of being needed. Now a staff member at The Hub through Recovery Corps, a program that trains AmeriCorps members for recovery-focused roles, she experiences that need in a positive way. "People today need me in a good way, and I love that," she expressed, highlighting a profound shift in her purpose.
JoAnn Fraley has observed a significant cultural shift 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,’" Fraley stated, indicating a growing acceptance and appreciation for the services provided.
Scott Lockard, the district’s public health director, points to both quantitative data and anecdotal evidence as substantiation of The Hub’s effectiveness. These include an increase in individuals entering treatment programs 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 diligently worked to educate the community about The Hub model, encountering minimal resistance and a strong desire to ensure funds were used judiciously. Fraley emphasized that individuals with lived experience of addiction have been integral to the planning process. "Their voice needs to be at every table," she insisted.
Lockard concurs, stressing the importance of community engagement in responsible resource allocation. "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.
Jannie Gatlin and Mandy Parker, both in recovery, recently participated in a crafting class at the Whitesburg Hub. Gatlin, who began using fentanyl in Colorado following the death of her infant son, now attends The Hub almost daily with her toddler, Hunter. Parker, who was initially prescribed opioids for a kidney disorder, turned to street drugs when her prescription access diminished. "That’s just the nature of the beast," she commented, acknowledging the compulsive nature of addiction.
Parker believes The Hub is instrumental in dismantling the stigma surrounding substance use disorder within her community. She observes a ripple effect as people witness "real change happening," which she asserts "makes a difference." The Hub’s accessible location on Main Street, Parker firmly believes, is precisely where it needs to be, readily available to those who need it most.
