what you say gives me this thought: the opoid crisis may be doing something similar to rural areas what the crack crisis did to inner cities in the 80's. With nationwide effects, of course.

Edit to add: it has been argued, and convincingly so to my mind, that trial and error changes in both culture and law enforcement after the crack crisis is what finally got a lot of urban crime rates down, and that took decades. For me, growing up and through the 80's, it always seemed that urban crime rates could only get worse or at best stay stable, never get better, no one thought it was solvable, it was like "the poor will always be with us", it was thought high urban crime was just a natural result of people with differing cultures living close together.

On the other hand, there would always be people like Woody Allen to make jokes how scary rural America was, the scary creepy quiet, the Ed Gein murdering monster types....the stereotypes that do a lot of damage among the uneducated, have to be addressed with humor...in the end, back to the "cultural exchange" of something like "Fresh Air Fund" can work wonders. Woody's character learned Annie's Grammy Hall in Maine or wherever she was wasn't as scary as he thought and wasn't always thinking about cooking and eating Jews.