It’s no wonder people voted for Donald Trump in USA - land of depression, despair and addiction
We’re driving through the snaking mountain roads of eastern Kentucky, high up in the Appalachians, and I have never seen anything so simultaneously beautiful and grim. It’s beautiful because it’s covered in lush green forest, much of it probably unchanged in millennia.
But it’s grim here, too, because of what lies between and beneath these hills.
In this part of Kentucky, outside of the towns, families tend to live in “hollows”, although locals pronounce it “holler”.
A hollow is often a small valley between the hills where the trees have been cleared and a homestead has been created. Often several generations of a family will live in a hollow, with sons and daughters adding their own small houses or trailers as the family grows. For this reason many of them are known by the family name — ‘Stewart’s Hollow’ or ‘Campbell’s Hollow’. Many of the names will be familiar to people back in Northern Ireland because many of the settlers in this part of Kentucky were Ulster-Scots.
There are other similarities, apart from just the names.
Religion plays a huge role in people’s lives here; tiny Protestant churches dot the landscape. Another thing that reminds me of home most is just how friendly people are to strangers.
Eat in any diner, have a beer in any bar, and you’ll be approached by people who want to welcome you to their town. Tourism isn’t much of an industry in this part of America, and our novelty as strangers seems to be in proportion to the warm welcome we are getting everywhere we go. These are good and decent people.
And yet, in the last two decades, they have been through hard times. Their trouble is written in the land, and in the hollows themselves.
At times the kind of poverty you’ll witness takes your breath away. For mile after mile we watch it unfold, one small trailer park after another, dilapidated and ramshackle. The BBC Panorama team I’m with are all well-travelled, and we all agree that some of the things we are seeing here seem more at home in Africa than in the richest country on Earth.
We’re here to do a story about drugs, or one drug to be precise.
Oxycontin is also known as “hillbilly heroin”. It earned the derogatory title when it seemed like addiction to the prescription painkiller was disproportionately affecting poor, rural communities. The epidemic has been going now for 20 years, and this part of eastern Kentucky was ground zero.
We have come here for BBC Panorama to find out why that is, and what we’ve discovered is disturbing. This part of America was always going to be fertile ground for a massive addiction problem. The coal industry once provided much of the employment here, but by the 1990s it was in decline. Unemployment was rising and the local economy was shrinking.
Working-class men and women who might once have expected a steady and decent income from coal mining and its ancillary service industries now found that there was no work, and no hope of finding any.
An aura of long-term decline settled in over the towns and the hollows. Kentucky didn’t seem to rate as a huge priority for help from Washington. People here began to get the sense that they were being written off as surplus to requirements. Crime began to rise.
Into this social tinderbox came Oxycontin, and other powerful prescription painkillers. Local doctors were told these drugs could be prescribed for most kinds of pain and that they were not particularly addictive.
There was a ready market for painkillers. Many people in these parts had spent their lives doing hard labour in a tough industry. Their bodies were broken.
Pretty soon there was no shortage of psychological pain either. It turned out that Oxycontin and other opiods like it were as addictive as heroin — in fact, they operated on the body in a remarkably similar way. Addiction skyrocketed — local GPs were astonished when their patients kept returning looking for higher and higher doses of the drug.
Dealers filled the gaps, and eastern Kentucky took another step into the abyss.
In the town of Pikeville I meet Kentucky State Police Sergeant Ronald Peppi. He’s a tall, wiry man, and a combat veteran of the war in Iraq, where he served with the National Guard. He saw terrible things over there — but he’s seen plenty in his own backyard, too.
As we drive around the county limits he tells me how much has changed in these parts since he was a young police officer. Back then the most serious crime might be a drink-driving offence or a bar room brawl. In a decade-and-a-half all of that changed. Unemployment, combined with the opiod addiction epidemic, means that he and his men are now regularly called to armed robberies of gas stations.
The police officers often patrol alone, and Sergeant Peppi tells me that the pistol at his hip isn’t the only firearm he carries. We pull over and he walks with me to the boot of his car. Inside is a powerful shotgun. He tells me in his languid Kentucky drawl that all of his men carry these now “for when you find yourself on your own and you need a little more firepower”.
He tells me that it was never like this before, but times have changed.
In Pikeville I meet Dr Bill Fannon, another military veteran, this time of the Vietnam War. As a local doctor he was one of those who prescribed opiods not knowing how addictive they could be — a few years later his own son died of an overdose. Hardly a family here hasn’t been touched.
But just as I’m leaving him Dr Fannon pulls me aside. “You know, opiods aren’t even the biggest problem round here,” he tells me.
I almost laugh — how could they not be?
“No,” says Bill. “The biggest problem is obesity — that’s killing even more people here, and even more quickly.”
Everywhere you look, it’s fast food restaurants: Wendy’s, Burger King, McDonald’s. You’ll drive a long way on these freeways before you come across a diner that’ll serve you anything that you might consider healthy.
Consequently, the levels of obesity are astonishing. On your first day in these parts you’re amazed at how many people are very overweight — by far the majority of the people you encounter. What’s even worse is that after a few days your perception shifts, and you only notice the people who are not overweight. These are the recent descendants of the pioneers who settled these parts; the men and women who cleared the hollows and who claimed the land by the sweat of their own brows.
But that was then, and this is now.
As we leave eastern Kentucky and cross the mountains into Tennessee it suddenly hits me; these people have been betrayed — and not just by Washington, but by corporate America.
The government may have taken away their jobs, but it was the corporations who filled the void with addiction to drugs, to sugar, to fast food.
These good and decent people, hospitable and religious, were seen as fodder for the corporate machine, as expendable engines of profit, and it has led them into a dark corner of depression and despair and anger.
My trip to Pikeville, Kentucky, was last year, but I thought of it again yesterday, and I looked up the results for that small corner of America.
Pike County voted 80% for Donald Trump and 17% for Hillary Clinton.
And, so there it is, I thought to myself — the hollows have spoken.
- Declan Lawn is speaking at the Cleraun Media Conference in Dublin this Saturday, November 12, on the subject of “Investigative Journalism in a post-factual society”