Mandi Fugate Sheffel was born in the heart of rural small-town America, in a place where "wild teaberry grows," with creeks "as clear and cold as nature would allow." As a curious, sensitive child raised in a challenging environment, she formed a deep bond with her cousin Eric. As the pair grew up together, they sought a sense of belonging, and drugs and alcohol provided a temporary escape from the harsh realities of their lives. Everything shifted when Purdue Pharma launched aggressive marketing campaigns for OxyContin in central Appalachia.

In The Nature of Pain, Sheffel recounts coming of age during the opioid epidemic of the late 1990s and early 2000s. She illuminates the importance of kinship and connection to place while exposing the bitter truths of a community transformed by opioids. With candid, lyrical prose, Sheffel reveals what life is really like for people in active addiction and recovery. Her lived experience as an eastern Kentuckian affected by the opioid crisis is an underrepresented story that must be heard. Sheffel's memoir is an aching tale of empathy for modern mountain folks—of love and grief, of family and place, and of the addictions that continue to pain them.

The book is published by The University Press of Kentucky. The audiobook is published by University Press Audiobooks.