During the late 1990s in the United States, rural Kentucky (and rural pockets of nearby states) witnessed the emergence of a new pharmaceutical drug of abuse. The powerful oxycodone OxyContin, first manufactured in 1996 and designed for time-release pain relief, found a ready population in rural hamlets and mountain communities. Intended for patients in pain associated with terminal disease, it became a drug of abuse as it was overprescribed and trafficked within newly developed black markets. This paper describes the takeoff of this new drug of abuse, its antecedents, its effects on rural communities, and coordinated efforts at containing it. Following the trends in use and abuse, this paper presents evidence of an epidemic created in part by organizations in both the private and the public sectors. The paper also describes the much publicized and alleged relationship between OxyContin use and increasing crime rates in Kentucky (and the surrounding Appalachian region). This paper shows that this drug-crime connection, propagated by media and government sources, has been socially constructed and bears little resemblance to empirical reality.
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