Tell me about your community and the communities that your coalition serves – its population and unique features. When was the coalition formed?

In the far southwest corner of Virginia, seated in the Appalachian Mountain range, is Tazewell County.  The County is spread out over 520 square miles and boasts a modest population of 43,100 residents. Historically, Tazewell has been identified as a “rural” or “mountain” community, with the primary sources of labor available through mining, construction, and logging enterprises. As a result of the topography in the area, the nearest urban centers are located in Bristol, Tennessee, Princeton, West Virginia, and Blacksburg, Virginia—which means that the only recreation available to residents is the bowling alley, a movie theater, and outdoors recreation. There is very strong faith-based culture in the community, and the majority of families share conservative attitudes and are very connected to churches.

Tazewell County is an intimately connected community– roughly 98% of the residents are natives and their families have lived in the area for more than two generations. However, to live in Tazewell County means that you are exposed to poverty, chronic health issues, an uncertain commercial market, and rampant substance misuse. In March of 2005, Tazewell received national attention for being the number one area in the nation plagued by prescription drug misuse. The community became known overnight as the place where “’junkies’ addicted to prescription pills [were] looking for anything to steal to pay for their next fix” (Time Magazine, March 2005).

As early as 2000, community members were aware of the increases in crime rates related to prescription drug misuse, specifically in the form of Oxycontin. Between 1997 and 2000, substance use-related crimes doubled. Schools noted increases in disruptive juvenile behaviors, and social service agencies were witnessing increases in the number of foster care referrals resulting from parent substance misuse. Almost a decade after Oxycontin was introduced to Tazewell County, local business owners are still being prosecuted for peddling drugs of many forms to school age students. Addiction within the county transcends economic and social barriers. Residents in recovery often find they are not eligible for public housing, and their conviction also limits their access to grants for education. A recurring cycle of addiction has developed.

SATIRA (Substance Abuse Taskforce in Rural Appalachia) is a substance misuse prevention coalition formed in October 2000 in response to the Oxycontin epidemic in our county.

What unique issues is your coalition facing?

“The southwest region has staggering death rates related to substance misuse,” said the coalition’s director Sharon Kitts. “The crime rate per capita in Tazewell County, which is predominately drug related, has been the highest in the state of Virginia some years. Tazewell County has also suffered many years from economic deprivations. Culturally, the community has prided itself on treading through hardships by the stronghold of the family system. Unfortunately, the acceptance of generational alcoholism and the growing prescription drug problem has deteriorated this stronghold.”  

“One of the health consequences of having such a labor-oriented economy is job-related injuries. For several generations, families have been working in the mines and fields and often experience injuries that come with chronic pain. This is one of the reasons that the narcotics epidemic is believed to have taken such a strong hold on the community. Unfortunately, when so many families have access to legally prescribed substances, and many of them show signs of depression and live in poverty as a result of job loss, substance misuse develops.” 

What activity or program is your coalition most proud of and/or what activity would you like us to spotlight?

SATIRA led the charge for Policy JFC-R.9 – Student-Athlete Substance Abuse, JFC-R.9.1, Drug Testing of Student-Athletes, and JFC-R.9.1.F, Student-Athlete Pledge Program and Parent Agreement. The Extracurricular Participant Pledge Program consists of a pledge signed by Tazewell County students who participate in extracurricular activities that says they will not use tobacco, alcohol, or any other illegal drug during the school year in which they are a participant in an extracurricular activity. Every pledge is also signed by the parents and/or guardians, who pledge to help their student live up to their promise. They also pledge to participate in the education, treatment program and/or disciplinary matters as may be imposed for their child’s failure to live up to the pledge.

How did you get there, and what are your outcomes?  (Be as specific as possible in terms of strategies that you used)

“SATIRA has made a huge impact on youth substance use in the Tazewell community,” said Kitts. “SATIRA works hand-in-hand with the school system and, according to the Superintendent, is the ‘primary resource to substance misuse prevention for the students.’ SATIRA works with CADRE (Commonwealth’s Alliance for Drug Resistance Education) to provide Red Ribbon Week activities in the Schools. SATIRA also partners with local law enforcement to conduct compliance checks, and with the regional coalition ASAC (Appalachian Substance Abuse Coalition) in our ongoing ‘We Don’t Support Underage Use’ campaign.”

“The partnership success with the Tazewell County School system takes many forms,” said Kitts. “Each year, SATIRA sponsors an event to bring motivational speakers to our schools; topics range from bullying to substance use. SATIRA provides student and parent education as well as handbooks and drug testing kits to parents. SATIRA is also actively involved in the faith and the recovery community.” 

What advice would you give to other coalitions that may be addressing some of the same issues?

“The regional prevention moto ‘Our Community Our Responsibility’ is a very important part of SATIRA’s accomplishments,” said Kitts. “Relationships in the community are invaluable and vital for a coalition’s success and sustainability. Prevention takes the entire community working together. Don’t fail to recognize how important the coalition sector members are to the coalition’s success. Ultimately, they live in the community by choice, know their neighbors, and are the ones who have a personal interest in the future and safety of their children.”