> 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).

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.