A diet of pure fat would literally be healthier than the diets of a majority of Americans. At least satiety is activated much sooner.
If we examined it, we'd probably find a number of preventable deaths per year far exceeding that from any drug use. Hell, the side effects of our dietary metabolic wreckage probably impel the search for comfort/escape in intoxicated states.
Of course simultaneously we're dealing with a breakdown of a post WWII script, in mainstream American society, where the dream is available if you work hard and your purchasing power will only get better as society "progresses". But for the average Joe, the price of everyday consumables (Food, gas, water) and shelter has outpaced inflation. At least electronic soma is cheaper!
For me, it's hard to extract our drug problem from the pervasive shitstorm of other factors.
PS: MXE was/is the shit. It's a damn shame such a relatively mild dissociative with a promising profile will probably never be allowed for public use until the current generation of puritan drug cop-regulators die off.
In 2019, you are more likely to die in the US of an opiate overdose than you are to die in a car accident. That staggers me.