These societies' problems are certainly not recent, and they're not just due to drugs. For Appalachia, read _Albion's Seed_ or at least Slate Star Codex's review ("the sensibility is positively Orcish"); for Sicily, read Peter Turchin's _War and Peace and War_ (watch for the section on "asabiyya black holes"), and probably _The Moral Basis of a Backwards Society_. Both of these societies have been absolutely awful for centuries.