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 the 12-month period ending last September—that’s about 150 doses

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