IME it's less about disability fraud and more about treatment of the physical injuries sustained from blue-collar work. Those faking it are the ones with enough foresight to sell their pills to others.
But you are otherwise right from what I've seen; the opiates are addictive, the demands of the job do not lessen (they only increase) and the rest writes itself.
As someone not steeped in it, I think the charitable interpretation is that these people like working a job for the dignity of supporting themselves. The jobs went away, but the desire for that dignity hasn't. So social welfare policies remain uninteresting. In fact any top-down analysis sets off their "government handout" detectors, so they're left pining for the age before the need for labor dried up.
IMO a lot could have been done (and perhaps could still be) by decreasing the definition of full time work. With technological progress, offshoring, and women entering the workforce, full time employment should be around 10-15 hours per week. It's a radical departure from the status quo, but that's due to progress being held back so long. Instead we're stuck between a rock and a hard place with an economy tuned to force people into working 40+ hours a week, but little actual work to do.
(BTW the work in cities is more about communication, so the same trend manifests itself as the creation of non-producing bullshit jobs. There is less financial pain, but similar existential pain)
Almost everyone just wants to be safe, happy, economically secure, and the same for their kids. That transcends nationality, religion, or party. I think trying to frame it around economic policy reversed the way the mindset was bootstrapped.
False claim
But you have to understand, the shift of manufacturing from the US has just devastated the economies of entire regions. You have children fleeing where their families have lived for generations. I'm convinced a factor in opiates getting a toehold in these areas was due to people going on disability to try to stay economically afloat, and getting prescribed painkillers as cover for faked injuries or in recovery for real but unneccessary surgeries (I have no proof, just anecdata).
US hegemony was good for them. It helped payed their mortgages and their kids' tuitions. It's easy to magnanimous when you aren't the one losing your house or kids aren't ODing from fentanyl. And the resentment is real when you see new grads at Google or Facebook making 10 times what you make, or CEOs making 1000 times what you make.
edit: the president did little, if anything to help their situation and channeled that resentment for his own benefit. It is a matter of national security that we all fix this and I hope the new administration will prioritize it.