Reads: People hid their drug use successfully. How much history do we need to experience before we accept that shame only leads to everyone pretending that something isn't a problem instead of addressing it head on.
I suppose it's possible that there were some other people besides this three people gang at least trying illegal substances, but it was still marginal enough to been a complete non-problem. Alcohol, however, was different; it was legal and socially accepted and many people had a problem with it.
> Alcohol... many people had a problem with it.
I think this disproves your entire point. We both know that problematic drinking isn't socially acceptable in those small towns. Especially with the religiousness. So probably a different factor that you're conflating.
Reads: Someone who can't comprehend that a lot of people actually don't want to do drugs.
I lived in a town of 20k people that was BY FAR the largest for an hour drive in any direction. Lots of drunks. First place I lived there, my neighbor was selling meth, put up a confederate flag in their window when a black lady moved into my duplex, and was shot 6 times later than year (survived, since we was shot by a shaky meth head who used a 22). They were banned from the place and police wouldn't do shit whenever they were back and they got mad at me when I demanded they take care of the screaming meth head at 6am on a Saturday. They stole parts off my truck. There were meth heads climbing their fence all hours and days. I literally watched a different neighbor get arrested by a cop who said "hey, don't we have a warrant for you?" (neo nazi guy, who just turned around and the cuffed him). When I moved later that year? Heard nothing. Wouldn't have known. Only thing was you'd still see grown men riding children's bikes because you know they lost their license. No one rode bikes there. Shit was dangerous as hell.
I went to college in a non-college town about twice that size (college was <2k people), and again, lots of drunks. Different sides of the country but both were very Christian and even had strict drinking laws. The uni didn't allow alcohol so a lot of kids were just drinking and driving (closest bar was a mile away and downtown was a 15 minute drive).
Look at a heat map of opioid deaths. Then tell me again how this is a problem exclusive to big cities. If it wasn't in small cities, you wouldn't see a looming crisis in The Blue Ridge. If it were shame, Utah wouldn't be an epicenter.
The thing is that humans are really fucking bad at statistics. We internalize them by total samples of the event, unnormalized. Which is already an incredibly biased lens. I guarantee you that several people in your town were doing drugs, you just didn't know. Just take a minute and ask your self "do I know what I'm talking about or did I just pull this outta my ass?" We need a lot more of that if we're being honest.
In places with diverse people from different backgrounds and cultures (i.e. all modern cities) there is no social contract. Apart from murdering people, there are very few things that people agree are universally good or bad, and thus the behaviour moderating effect doesn't exist either.
As someone who was raised in a very small town with sort of strict culture (didn't really seem like that to me at the time, but by modern urban standards it was that), I can very easily see how the cultural relativism leads to all kinds of social problems in western urban world. In my town no-one did drugs, because that would have been shameful. People around you (all of them to some extent) are important, you are important to them and you care about what they think about you, and as a result you don't want to do stuff that will look shameful in their eyes. Without this guidance from other people, (some) people end up going down into rabbit holes of drug habit, alt right, etc.