I'm glad this article is highlighting the environment that this happened in. The lack of hope is what is at the root of the issue for many. If you have no decent job prospects and multiple issues in your life, you won't care about what a drug will do to you as long as you get to forget those problems for a while. Pretty similar for alcohol too.
They blame the coal barrons for not leaving anything behind. They certainly had some problems, but many of those were handled a generation before the closures, especially for the union mines. The problem was more systemic than just coal barrons leaving nothing there. You had multiple entire industries essentially die off. Mines closed, steel mills closed, many factories closed (a lot of shoe, textile, and home goods). Part of that was consolidation from local and regional brands into national ones. Another large part of it was globalization and outsourcing manufacturing to cheaper markets. So what were these barrons expected to leave behind if there were no jobs to create? It seems to me the blame lies more with the CEOs of the national brands and the sectors that replaced manufacturing. We don't see any real tech presence in the smaller Appalachian cities (aside from some pork barrel defense firms in a couple). Instead, we have a vicious cycle of population concentration and all the problems that come with that.
I am more aghast at the pharma barons that have retained their wealth, as that was a quick cycle of unequal riches and ruin that looked nothing like the impact of coal upon society (as it was able to empower industrialization for a long duration). There was no long-duration benefit to OxyContin mass-marketing.
That the Sackler family remains at liberty is conclusive proof that the FDA was bought and owned on the question of opioids, and had no ability or intention of acting in the public good. Most other countries would have stopped this.
A similar theme pervades most of the checks and balances of the U.S. Constitution in general. These were brilliant controls in 1789 that have long since been disabled by an ocean of cash.
The biggest problem is/was the quest for greater corporate profits, which drives consolidation, cost-cutting, offshore outsourcing, reducing the power of the unions, product enshittification, etc.). When the mission of a company is to deliver value to its shareholders -- the mantra of capitalism -- this is the end result, and it's highly destructive. We saw it at the end of the 19th century, and we're seeing it again from the end of the 20thC until now.
While that is largely true, I don't see another scheme that would be unaffected. For example, a lot of what happened with consolidation was also due to efficiency and economy of scale, which would still be desirable even if profits weren't the main motive. The offshore and outsourcing has more to due with trade imbalance (not necessarily overall, but within specific sectors) and consumer preference (race to the bottom) than with profits. I think imbalance of where the profits end up is the bigger issue than profits themselves - the higher ups and the people with capital make sure they get a bigger slice of the pie while the average people/workers are left behind.
They blame the coal barrons for not leaving anything behind. They certainly had some problems, but many of those were handled a generation before the closures, especially for the union mines. The problem was more systemic than just coal barrons leaving nothing there. You had multiple entire industries essentially die off. Mines closed, steel mills closed, many factories closed (a lot of shoe, textile, and home goods). Part of that was consolidation from local and regional brands into national ones. Another large part of it was globalization and outsourcing manufacturing to cheaper markets. So what were these barrons expected to leave behind if there were no jobs to create? It seems to me the blame lies more with the CEOs of the national brands and the sectors that replaced manufacturing. We don't see any real tech presence in the smaller Appalachian cities (aside from some pork barrel defense firms in a couple). Instead, we have a vicious cycle of population concentration and all the problems that come with that.