BURNAWAY > Interview > Which Side Are You On: Queer Appalachia and the Opioid Epidemic

Which Side Are You On: Queer Appalachia and the Opioid Epidemic

Installation view of Mamone’s Which Side Are You On at Sheherazade in Louisville.

Last fall, I spoke with West Virginia-based activist and artist Mamone, who runs the popular Instagram account Queer Appalachia, on the occasion of an exhibition of their work at Sheherazade, a storefront exhibition space in Louisville, Kentucky. Since launching in 2016, Queer Appalachia (QA) has worked both online and IRL to connect and advocate for queer folks throughout the South and Appalachia, functioning both as a digital resource and community artist collective. In their exhibition at Sheherazade, Mamone presented a large scale print of Which Side Are You On, a poem in the style of Zoe Leonard’s 1992 work I Want A President, which was on view twenty four hours a day through the gallery’s large storefront window. Mamone’s poem echoes similar concerns to those present in Leonard’s original work but specifically addresses  challenges common in Appalachia and the South, emphasizing the effects of the ongoing opioid epidemic on these often marginalized regions. Our conversation was conducted via email from November 2018 through January 2019 and has been edited for publication.


Paul Michael Brown: Before we get into Which Side Are You On and the exhibition at Sheherazade, can you talk a little bit about yourself and Queer Appalachia?

Mamone: Queer Appalachia started as a memorial zine project, and with no intention whatsoever we accidentally became the first rural, queer digital community. Appalachian geography is vast and remote, and queer people have been here as long as people have been here. We have enough technology at this unique time in history where we can finally connect. Two and a half years into the project, we have grown into so much more than a zine.  Everyday hundreds of thousands of followers on our combined social media platforms connect with each other and build community digitally and IRL.

The first zine was two hundred full-color pages, and there was one piece in it about queer opioid addiction in Appalachia. The first month after publication, over half of the inquiries we got about the zine were about this one piece. So many people who identified as addicts or as users were reaching out to find community and resources while sharing their stories. We put together a survey and spent the next month collecting data on a sample of folks who had written in. It’s the first data ever collected about queer opioid addiction in Appalachia. We will be publishing it with West Virginia University Press next year. What we found was shocking. The resources that are available to the straight community around addiction and recovery do not translate to the queer community in any way. In fact, if you present outside of the binary, it might not be physically safe for you to even attempt to go to a Narcotics Anonymous meeting. We started building QA Recovery shortly after: a digital, peer-led community that is open 24/7. Our administrators and moderators have at least five years of sobriety and are queer Appalachians themselves. They truly understand the nuanced reality that the people on the other side of the screen are navigating. We even offer e-sponsors through the program.

Our response to queer Appalachians navigating the opioid epidemic was nothing we ever planned on doing. Learning of the need in our community is what led us to take action.

Still from a video promoting Electric Dirt, Vol. 1, the first zine produced by Queer Appalachia. (Image courtesy Queer Appalachia.)

PMB: Which Side Are You On echoes the form and some of the concerns of the 1992 poem ‘I Want a President’ by Zoe Leonard, which was written largely as a condemnation of the shortcomings in the political response to the AIDS crisis. Which Side Are You On offers a similar response for the opioid crisis in rural America. Can you talk more about some of the intersecting problems facing Appalachia that have contributed to the opioid crisis there?

Mamone: Our working class culture that focuses on a mono-economy of coal puts the region at a disadvantage from the start. Manual labor jobs that are some of the most dangerous in the region often breed a specific, nuanced type of toxic masculinity. You can see it in our politicians as they vote against the best interests of the environment and other industries coming to our hills and hollers. The human body ages, and as we get older that wear and tear really shows. These are dangerous, grueling, physically demanding jobs. There’s only so much time you can take off to heal. There are only so many afternoons you can take off to go to physical therapy, if you’re even lucky enough to have insurance to cover that. The majority of Appalachians aren’t looking to throw their life away or hurt and destroy everything they love. They come through pain management rehabbing injuries and trying to keep the lights on and food in the house.

The cycle of intergenerational poverty is another factor. I grew up in the coalfields of West Virginia. I went to school with two types of kids: those who knew they would be able to go to college, and those who knew leaving would never be an option. In the latter case, they’re often in debt that there is no mathematical way possible to ever get out of, and they feel lucky to have a shitty job. There comes a time when people understand that things probably aren’t going to get any better, that there’s nothing they can do about it other than accept it. These days, while trying to navigate that in real time, thanks to the internet and capitalism, you can see everything that everyone else has, 24/7, in the palm of your hand. Feeling like you have nothing to live for and self-medicating is understandable. For capitalism to work there have to be people at the bottom, at the very bottom, and some people will never know what it’s like to not feel that boot on their throat.

All of these natural paths to addiction become exacerbated when there’s so much money to be made in us killing ourselves. I see the pharmaceutical industrial complex following the same business plan that coal companies have. Appalachians have always been disposable for the right price—the coal camps were built on that business plan. Opioids have become another extractive economy like coal, ramps, morels, and natural gas. They finally put a price point on our dignity and actual lives. As long as our politicians paint addiction as a moral failure, the rest of the community will just think that the trash is being taken out. In this last election there were actually people who ran on platforms arguing that you could only get saved once from an overdose. The next time someone called emergency services, they would need to pay before life-saving precautions could be made.

I see Appalachia’s politicians at every level—from the city to the county—making so many of the inexcusable things that happen around here completely legal. There’s a reason why it’s cheaper to pay fines for safety infractions in the mines than to actually fix the problem. No coal miner voted for that. I hate to admit it, but [coal executive] Don Blankenship is right: he never broke the law.

The text of Mamone’s Which Side Are You On? (2018).

PMB: A few groups have used the format from I Want a President to discuss other issues, especially in the last two years. Two examples that immediately come to mind are Luis Felipe Fabre’s Quiero un Presidente  and We Don’t Want A Disaster for President from the collective What Would An HIV Doula Do? (WWHIVDD). What led you to emulate Leonard’s format to discuss the opioid crisis and its specific effects on Appalachia? What is it about Leonard’s piece that makes it an attractive tool for translating different needs and concerns?

Mamone: Now that you mention it, the WWHIVDD collective was organized by friends of Bryn Kelly, in whose memory the QA zine project originally started, as I previously described.

I feel that ‘I Want a President’ took on a life of its own during the 2016 presidential election. The first time I shared Leonard’s piece on the QA Instagram was right after there was a change in the debates in October. Trump started doing socially unacceptable things during the debates: he was lurking, standing very close… He was breaking social mores and norms in a way that we didn’t do on live television until then. During this time a lot of people felt that Hillary had it in the bag because they couldn’t imagine how you could vote for anyone who would do that and think it’s acceptable to conduct themselves in that manner on live television. Watching all of this unfold in real time while running a social media project that’s in a constant state of generating regionally specific content made me draw certain parallels in my mind. It seemed like the rest of the world was finally getting the irresponsible, opportunistic, self-gratifying political representation that Appalachia has had all along.

As I’ve mentioned previously, I don’t feel our politicians—the majority of them—care about what is in their constituents’ best interest. The headlines in my local paper make me dizzy: wind turbines are illegal on mountaintops because they would be unsightly and ruin the view, so there’s no other choice but mountaintop removal. When I first moved home from Brooklyn, there was a huge chemical spill in Charleston not too far up the road from where I live. The devastation to people, wildlife, and the watershed was epic and heartbreaking. In the days afterwards, it came out that nothing illegal had happened to the extent which people had thought. As much as there was an accident, the container that leaked had a decade of safety violations on it. As long as the company paid its fines, nothing illegal was happening, so it didn’t matter that communities were in danger. I understood that our country was about to get a taste of what Appalachia has lived with for decades. I couldn’t help but wonder what my ideal Appalachian political representatives would look like.

I grew up in a world where I was taught that it’s all [company] scrip. The company store just got much bigger and has some complicated patriotic branding. There’s never been adequate representation in Appalachia. Even the first security guards worked for the coal companies. They were here to protect their interests, not those of the individuals in the camps. When I look at pictures of Standing Rock or pipeline protesters who are literally in my backyard in tree sits against the Mountain Valley Pipeline, I don’t feel much has changed since the first coal camps in the region. Our tax dollars are paying people to literally guard confederate statues and arrest people for feeding the homeless. At every level, the government is focusing on protecting corporations and their profits, and people are reduced to optics and collateral damage for the sake of the bottom line.

PMB: Can you talk about your collaboration with Prescription Abuse Intervention Now (P.A.I.N.), the activist group founded by artist Nan Goldin to hold the Sackler family, whose pharmaceutical company produces OxyContin, to account? It’s exciting to see that there’s some real solidarity forming across urban and rural boundaries to address this issue.

Mamone: It’s been so inspiring to see how P.A.I.N. is using Nan Goldin’s platform and resources to not just change the conversation but demand it, all while simultaneously giving a language to the masses to talk about addiction. Something as simple as the hashtag #shameonsackler or #sacklerliedpeopledied is a gift to the addict/using population of the Appalachian region. So much of the conversation around fault and addiction is built on a foundation of moral failure. [Venture capitalist and author] J.D. Vance’s career is built on this ideology. Appalachia is the buckle of the Bible belt in many ways, and so many parts of our culture reinforce the notion that bad people do drugs, not that drugs can make you do bad things. The hashtag language used in the P.A.I.N. project is groundbreaking and something Appalachia has been in desperate need of for a very long time. It shows the truth of who is really at fault.

The legislation that P.A.I.N. helped introduce with Elizabeth Warren last year is the most hopeful legislation I’ve ever seen for our region, allocating one hundred billion dollars with a focus on treatment and community building. Just this past week, documents have been filled by the attorney general of Massachusetts against Purdue Pharma which claim that the Sacklers knew from the very beginning how addictive and deadly opioids were. “We have to hammer on abusers in every possible way,” Richard Sackler wrote in a 2001 email. Part of their initial business plan was to blame the people that became addicted. “They are the culprits and the problem, they are the reckless criminals,” Sackler said.

Artist Nan Goldin staging a “die-in” at the Harvard Art Museum in 2018. (Photo by TW Collins, courtesy of artnet News.)

The P.A.I.N. project is not just giving us the necessary language but also context for it. So much of the media that focused on this region after the presidential election seemed to come from the perspective of ‘What did these dumb hillbillies do to us? Well, look what they do to themselves.’ We now have the language to change the conversation regionally and actually hold those responsible accountable. What if the money that the Sacklers spent in museums was instead spent on treatment in the areas that suffered the most for their profits? If the Sacklers want to clean their money and gain cultural equity, let it be for doing the right thing.

The work that I do can be very isolating. I have about a two-and-a-half-hour drive one way if I want to see another person in my community. There are hundreds of thousands of people on the other side of my phone, but that doesn’t seem real sometimes because I live so remotely. It means the world to have folks that I can share articles with and unpack some of these really dense legal and medical texts alongside. QA lives off original content curated specifically for our key demographic.  A big part of my job is to take national news and repackage it for a regional lens. The first piece on the opioid epidemic to include a regional lens from the beginning that I’ve ever seen in my life was our first official statement issued with P.A.I.N. this past fall. For regional people who do this work—whether it be in the trenches with addiction work, legislative work, or harm reduction—it was a big deal to be represented in national headlines in a proactive way that wasn’t followed by some heartbreaking statistic. Almost daily someone reaches out to me to let me know how excited they are to see the rural opioid crisis represented and included in the national conversation, still all these months later. I’ve spoken at length about how many people don’t care about Appalachians, even the people who we literally pay to care about and for us. That makes support from unsuspected sources all the more moving.

Cover of Feminary vol. 10 no. 1 (1979) from the Sallie Bingham Center for Women’s History and Culture at Duke University, Durham, NC.

PMB: One of the most interesting and vital things about what you’re doing with the QA platform is that you are making real, concrete changes for queer folks in the region, in addition to spreading information and generating some quality memes in the process. Can you talk about some of the initiatives you have helped fund and raise awareness for, and any other projects that have bridged the gap between online spaces and those IRL?

Mamone: I’ve already talked a little bit about QA Recovery. All of our proceeds go back to our community through our micro-grant program. We fund everything from art installations to antifa street medic training to queer music festivals. Our hope is that we can reimagine the cultural landscape of queer Appalachia together so that there is more of everything: art, culture, community spaces, queer healthcare, safety, bathroom access, queer elected officials, and beyond. We also host meetups and events.  This past year, we co-hosted the West Virginia Zine Fair, several readings, art shows, music festivals, a three-day camping event called Farm Show, and over a dozen political actions.

We are currently have a community coat drive in full swing. In November, we got a grant request from some folks asking for winter coats. They explained how poor they were and how they could not access the clothing closets in their community with dignity. I thought we could raise enough in one night to cover the cost.  I was not prepared for what happened when I put the request on the internet.

I learned that it’s a pretty standard experience for rural queers to not be able to access these community resources with dignity. I heard about all the different ways Christian-affiliated organizations have kept these resources from cold, poor people, down to some places only giving you clothing that matches the gender marker on your identification. I elected to not make any art for the coat drive and just started sharing screenshots of people’s emails describing the pettiness and cruelty they experienced while seeking help.

This led to even more emails coming in and literally thousands of requests. At our highest number, we had over eight thousand requests for coats. We’ve been taking donations monetarily and in the form of gently used coats. There are some local dry cleaners who are being amazing and donating their services to clean the coats, and we are getting them out as fast as we can. Going into February, our coat request list is around four thousand people long.

Many of us have gone through our health departments’ needle exchange training, and I completed my harm reduction training instructor course this past spring. We’ve done a couple pop-up needle exchanges and test strip/Narcan trainings that correlated with speaking engagements, and we’re looking forward to doing more of that in the future.

PMB: National media has a nasty and well-documented habit of portraying Appalachia and its inhabitants poorly and inaccurately. Where can folks find accurate reporting and storytelling on the opioid crisis and other issues affecting the region?

Mamone: Follow P.A.I.N. (Prescription Abuse Intervention Now) for opioid news in real time. If you prefer a more curated feed of people who are working full-time in the region and are focused on our culture and quality of life, follow Elizabeth Catte, Robert Gipe, Beth Macy, Roger May, Cornbread Communism, and Traveling Appalachian Review.

Mamone’s text installation Which Side Are You On is now on view at Gradient Project Space in Thomas, West Virginia, and will travel in March to 130 Gallery at Western Carolina University in Asheville, North Carolina. You can find more about Queer Appalachia at their Instagram (@queerappalachia) or their website (www.queerappalachia.com). 

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