Years ago, when Brad Paisley was racked with pain from a ruptured disc during a trip, a long-forgotten doctor gave him a prescription for OxyContin with instructions to take it as needed.

“I knew enough at that point,” Paisley remembers, “to rip it up.”

But the experience also gave him enough information to understand how his home state of West Virginia had become ground zero for an opioid crisis. Paisley and co-writer Lee Thomas Miller (“In Color,” “It Matters to Her”) addressed the topic in “The Medicine Will,” a gripping overview that appears on Son of the Mountains: The First Four Tracks, an EP released Sept. 29 that teases his next album. They could have easily turned “Medicine” into a trudging ballad of anger and grief, but instead embedded it in a midtempo package that hints at the strength of resilience. Though to be clear, anger is distinctly buried in there, too.

“I really do believe that this might be the best song I’ve ever written,” notes Paisley. “I can say that humbly. I do think that it’s as important as anything I’ve ever written — whether anything I’ve ever written is important. It feels that way because I know what it can mean to where I’m from. If you’re going to write a song about where you’re from, you want it to do some good.”

Paisley was already deep into the creation of his next album when Miller watched the Netflix series Dopesick, which premiered Nov. 10, 2021.

“It’s very damning,” Miller says. “It’s not a feel-good 30-minute [sitcom], but the more I researched after watching it, it was pretty accurate.”

The project documented how Purdue Pharma, owned by the Sackler family, twisted government connections and processes to con a vulnerable population into believing that OxyContin was nonaddictive. The company persuaded two congressional Republicans — Tennessee’s Marsha Blackburn (now a senator) and Pennsylvania’s Tom Marino (no longer in Congress) — to introduce a bill that made it difficult for the Drug Enforcement Administration to penalize drug companies. Once it passed, Purdue specifically induced coal-mining communities in West Virginia, eastern Kentucky and western Pennsylvania to use OxyContin to quell the pain caused by back-breaking work. Some 12 million pills were shipped to Kermit, W.Va., a town of just 350 people. As a result of the campaign, one county in the state estimated 10% of its population was opioid-dependent.

“Everywhere where [drug companies] should have been shut down, they doubled down,” says Miller. “They knew they would make all this money — I mean, they made Saudi Arabian money.”

Watching Dopesick, Miller scribbled down a thought: “If the livin’ here don’t kill you/ The medicine will.” He brought the hook and the topic to Paisley, who admits he was skeptical: “I said, ‘Yeah, I think that’s an interesting idea. I don’t know how good a song it would be.’ That was my instinct.”

But they toyed with it anyway at the bar in Paisley’s home studio, The Wheelhouse. Paisley established an acoustic guitar feel that sounded as dark as “Whiskey Lullaby,” and he grew more positive about the idea once he had the twisted opening lines to the chorus: “There’s coal under the mountains/ And gold in them there pills.”

“Whenever I play it for somebody, I watch their eyes because I need to make sure that they hear the word,” Miller says. “Once you get the word ‘pills,’ you know what we’re talking about.”

They sketched out some of the song’s repetitive themes, particularly one built around digging holes. They addressed digging the mines, digging graves for overdose victims and digging a hole that’s “hotter than the sun” where the Big Pharma executives can roast for eternity.

“No one’s gone to jail yet,” observes Paisley.

He “wrestled with the melodies,” he says, careful to make it inspiring and listenable, but not Pollyannic. Ultimately, the structure builds from a dark-sounding verse to a transitional pre-chorus (Paisley calls it a “channel” because it works almost like a mine shaft, transporting the listener to the next section), ultimately reaching an energetic chorus, offset by the stinging bite of bluegrass harmonies. Once they had a verse and chorus completed, Paisley went to the studio upstairs in a converted bedroom and put down an instrumental bed.

They continued working on “The Medicine Will” for several weeks, chipping away until they had a song that told the story without naming names and without wallowing in victimhood. Much of its power rested in their ability to shape a narrative that plays out like a news piece but still feels like a call to action.
And when the band swung into action, “The Medicine Will” found its full expression. Working with co-producer Luke Wooten (Dierks Bentley, Dustin Lynch), Paisley augmented his road crew with three bluegrass pros — Dobroist Jerry Douglas, vocalist Dan Tyminski and mandolinist-vocalist Sierra Hull — whose presence underscored the Appalachian foundation of Paisley’s home state. Midway through tracking, Kenny Lewis switched from an electric bass to an upright model, enhancing that acoustic sound, though Paisley wasn’t strict about following the bluegrass tradition.

For starters, he still utilized drummer Ben Sesar on the track, and he added burning electric guitar at a later date. Additionally, he had Kendal Marcy apply a Hammond B-3 organ. Like each of the eight instruments in the mix, it gets subtle moments to make its presence felt without ever dominating the proceedings.

“That was one of the pieces of glue because if you’re going to make a song about this area of the country, it’s not all just bluegrass,” Paisley says. “There’s something about that B-3 that feels churchy.”

While he worked on “The Medicine Will,” Paisley heard from Sen. Joe Manchin (D-W.Va.), who — unaware of the song — invited the singer to appear June 1-2, 2022, at a GameChanger prevention education event in White Sulphur Springs. Paisley performed the song live for the first time at the bipartisan gathering for 500 kids. He later shot a video in a Beckley, W.Va. mine.

“I can’t even express what that was really like, standing there singing and the water trickling, and the echo of it, and you’re however-many-hundred feet below the ground,” recalls Paisley.

The video features a number of recovering opioid victims as well as Manchin, who confirms the pharmaceutical abuse behind “The Medicine Will”: “They preyed on the people who did the hardest work, who sacrificed the most, because they figured they’d be the most dependent.”

“The Medicine Will” fits into a bigger arc in Paisley’s public persona. His recording of “Same Here,” featuring Ukrainian president Volodymyr Zelenskyy (included in the new EP) and his participation in The Store, a grocery outlet that provides free food for needy Nashvillians, demonstrate his intent to use his platform for something bigger.

“It would be so much simpler, easier, to just be like, ‘OK, here’s a song about love, or a situation, or something funny,’ ” Paisley says. “But that isn’t what I’ve done. For better or worse, this is a phase of my career where I have to say something.”