High above the street, Greg Puckett paints his 31st mural. To Puckett, a mural is more than a pretty picture on a building: it’s a way to build community pride, and ultimately save lives.

“If your environment sucks, so does your attitude, and so does your perception of wanting things to be better,” Puckett said. “When environments change, so do attitudes and so do behaviors.”

Puckett is a Mercer County, W.V., commissioner and CEO of Community Connections, Inc., a prevention organization serving Southern Appalachia. His perspective draws on theoretical frameworks of prevention, but his method is all his own.

“I have my own bucket truck,” he said. “I love big. I don’t like canvas art.” His largest mural was 30 feet high and almost 80 feet long. It took two weeks to finish.

He draws out the mural, then projects it onto the wall, getting contributions or grants to buy paint. “I love to paint gas stations,” he said. “Those are my favorites.”

His newest mural, in the atrium of Bluefield Middle School, shares an anti-stigma message with hugs in bright colors and the words “Break through isolation with community. Break through addiction.”

Multiple murals grace the Mercer Street Grassroots District in Puckett’s hometown of Princeton. His work has earned him a national award from Americans for the Arts in public arts leadership.

Environmental change to prevent substance abuse is a life-or-death strategy in Mercer County, which has been on the front lines of the opioid epidemic since oxycodone hit at the end of the last century. Puckett correlated rising prescription pain pill use with consolidating schools, small community dysfunction and economic struggle. 

“If you have good economics in your community, substance use goes down,” he said. “Negative behaviors go down. It’s not all perfect, but if you can push to give pride in your community, those negative behaviors will change and those negative factors will start to go in the right direction.”

Though prescription pain med misuse has declined in southern West Virginia, Mercer County still had an opioid dispensing rate of about 45 prescriptions per 100 persons in 2023, about eight points higher than the national average.

Community Connections, Inc., sponsors family support centers, youth camps, quick response teams and many other programs. Federal support for prevention has come from Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Justice and opioid settlement money paid by pharmaceutical companies.

Mercer County has also become a pilot county for a West Virginia Department of Environmental Protection program to remove damaged and irreparable structures. “We tore down over 300 structures that were dilapidated and blighted,” Puckett said. “We probably have 1,500-plus structures that need to be torn down.”

So far, the EPA has funded about $3.3 million in demolition in Mercer County, which leads the  state in program use.

Puckett sees a range of strategies as essential for drug prevention and resiliency. “It’s dealing with social norms, changing the physical design of the local environment, keeping things in our stores away from kids’ sight lines,” he said. “So it’s literally physical design, and revitalizing communities. We put paint on walls, and we change the way our communities look through murals and through cleanliness.”

A lifelong area resident, Puckett now travels frequently in his role as second vice president and on the opioid task force of the National Association of Counties. “I travel everywhere, but no matter where I go, this is still home, and it’s still worth fighting for,” he said.