As a child, I spent my share of time in my father’s hometown, the northwestern Massachusetts hamlet of Greenfield. A patchwork of rolling pastures with a main street that seems sprung from those light-up Christmas figurines, Greenfield is dozens of miles removed from the Boston hubbub and, it seemed as a kid, outside the jurisdiction of civilization itself. It still calls to mind the creak of my grandfather’s rocking chair, glimpses of the dairy farmer across the road, checks of my watch after an hour had seemingly transpired only to find it had been fifteen minutes. Serenity reigned there; a white church steeple peeked over the treetops.

Today, Greenfield is one of the epicenters of the heroin epidemic that originated in . . . is it New England? Baltimore? Appalachia? No one knows for sure, but it metastasized outwards from all those places until it reached the capacity of national crisis. One of its main smuggling routes is I-91, known as the “Heroin Highway,” which runs right through Greenfield. The town’s dope addiction has gotten so bad that travel journalist Anthony Bourdain recently profiled it on his CNN show Parts Unknown. Asked by Bourdain who these heroin buyers are, one anonymous former dealer sighed, “Practically all of Greenfield.” “There’s going to be more robberies,” she warned. “There’s going to be more killings.”

America’s last heroin flare-up began in the late 1960s, but it was confined mostly to the inner cities and had largely come to an end by the 1980s, when it crashed into the crack epidemic. Still, heroin lingered. In her brilliant investigative series “Heroin in America,” my Rare colleague Yasmeen Alamiri chronicled the dope problem in Baltimore, which dates back to the end of World War II, yet for decades received little attention outside of the HBO show The Wire. It wasn’t until heroin starting appearing in middle-class New England neighborhoods like Greenfield that the national headlines blared. Alamiri talked to a number of families in New Hampshire affected by heroin, all of them white, relatively well-to-do and wondering how a drug they’d previously heard about only in the papers had invaded their Main Street USA.

The origins of the heroin outbreak lie with the pharmaceutical companies, which compelled doctors to write promiscuous prescriptions for opioid drugs starting in the 1980s. The revolutionary breakthrough came with Oxycontin, debuted in 1996 by Purdue Pharmaceuticals. Oxycontin could relieve pain for up to twelve hours per dose. It was also chemically similar to heroin. Users addicted to heroin found that snorted or injected Oxycontin was a seamless transition, and vice versa. Doctors began overprescribing, especially in communities that were dependent on mining and physical labor, which yield more cases of chronic pain. That meant Appalachia, where abuse of Oxycontin, locally dubbed “hillbilly heroin,” exploded. “There’s no doubt it’s very much a plague,” one native of Gilbert, West Virginia, told the Associated Press in 2001.

One of the many Appalachians who developed an addiction to opioids was the mother of J.D. Vance, author of the new book Hillbilly Elegy, a memoir-cum-crash-course in white working-class culture for us Acela Corridor softies. Vance portrays a people whose kindnesses are larger than life—his grandmother, or “Mamaw,” saved him from neglect by raising him—but whose shortcomings are equally grandiose: addiction, marital dysfunction, random acts of violence. In Tom Wolfe’s novel I Am Charlotte Simmons, little ingenue Charlotte departs Appalachian North Carolina for a state school where she’s gradually corrupted; in Hillbilly Elegy, Vance has seen more before he turns eighteen than most of us ever will.

This was the white working-class crisis in its Precambrian period. What sent it creeping into sleepy hollows like Greenfield isn’t clear. What is known is that heroin isn’t its only symptom. The suicide rate among whites has also skyrocketed, up 80 percent among white middle-aged women between 1999 and 2014, per the National Center for Health Statistics, even as the same figure for black men ticked downwards. Mortality rates for whites have overall been falling, but so-called “deaths of despair”—suicide, drug and alcohol overdose, chronic liver disease—still shaved six months off average white life expectancy. According to Pew, 52 percent of white voters believe life has gotten worse for them over the past fifty years.

White America is trapped in a state of malaise. Fortunately, President Obama has yet to don a cardigan, but neither has he shown much interest in ameliorating anything, choosing instead to thunder about positive GDP data, which masks the scope of the problem. More perceptive economists and policy journalists might try to tease out an empirical solution. No doubt right now the Vox.com gang is assembling via conch shell to read up on their Great Society and start crafting a new tax credit or spending program or nudge that will relieve white working-class pain, to be paid for by a carbon levy and explicated on a colorful flow chart.

Vance is far more skeptical. Growing up, he became so frustrated watching his neighbors abuse food stamps that it turned him off the Democratic Party. “I could never understand why our lives felt like a struggle while those living off of government largesse enjoyed trinkets that I only dreamed about,” he fumes. He warns that Appalachian culture “increasingly encourages social decay instead of counteracting it.” He’s far from alone: National Review writers David French and Kevin Williamson, who also come from hardscrabble backgrounds, have echoed Vance’s criticisms. The children of the working poor seem to be its toughest critics.

Elsewhere Vance writes:

People sometimes ask whether I think there’s anything we can do to “solve” the problems of my community. I know what they’re looking for: a magical public policy solution or an innovative government program. But these problems of family, faith, and culture aren’t like a Rubik’s Cube, and I don’t think that solutions (as most understand the term) really exist.

This is anathema to Washington’s social engineers, who imagine every void can be filled by a well-intentioned public policy. It forces them onto deeply inhospitable terrain: the cultural, the intangible, even the spiritual. By the end of 2012, 35.4 percent of Americans were receiving one or more forms of government assistance, and the number climbs to almost half if you include those on Social Security and Medicare. Is the same arsenal of welfare programs that failed in Appalachia somehow going to save Greenfield and Manchester? Clearly, there’s something else at work here.

Actually, that might be too dismissive. Government does have a role to play, especially where fighting heroin trafficking is concerned. And there’s no denying that bad economics feeds bad culture, especially when we’re talking about a financial crisis that stripped the American economy of more than $22 trillion. The shock of the recession accelerated existing trends, away from manual labor and towards automation, and created new ones, like permanent unemployment for some and endemic underemployment for many more. This was felt intimately by whites outside major urban centers, where voids left behind by manufacturing were often filled by eds and meds, which required skills they didn’t have, or the service industry, which didn’t provide sufficient wages. The impact was psychological as well as economical, and sometimes begged for remedies that were chemical and even mortal.

Still, Vance is correct that government doesn’t hold the key to the white working-class riddle, and in some areas it’s been downright destructive. I was once in a remote bar in western Pennsylvania when a guy in a baseball cap and flannel—my sartorial opposite—struck up a conversation. What did I do for a living? I told him I was a writer in DC and waited for a scolding. Instead, he bought me a drink. “Go to West Virginia,” he instructed me, “where I’m from. Go see what this Obama’s doing to the coal workers. And the natural gas guys are nervous, too.” West Virginia is the sole state in the union that over the past decade has flipped from blue to reliably red. The main reason can be explained with only three letters: E-P-A. For white workers, many of whom were old-school FDR Democrats, the government that once championed their interests has betrayed them.

Has a certain real estate mogul appeared in your head yet? Betrayal of the white working class is Donald Trump’s raison d’être. Some of his solutions are flatly wrong (tearing up long-standing trade deals), while others are more sensible (reining in the environmental bureaucrats), but he has at least tapped into the problem—and if he sounds apocalyptic, well, so are the lives of many of his voters. To them, this crisis feels external: the drugs came from outside the community, didn’t they? And the workers sure as hell didn’t send the plant packing. Trump plays into this by offering an ever-expanding bestiary of alien enemies: China, Mexico, immigrants, the political class—and if the damage originated on the outside, maybe salvation can begin there, too, with a Queens tycoon who’s tired of getting fleeced by “fahreign countries.”

Speaking of which, there’s a foreign-policy component at work here. A mystique surrounds America’s military in places like Appalachia, where residents disproportionately enlist. The past fifteen years have sent them to wars in far-flung locales, only to unleash a hornet’s nest of the same terrorists we were supposed to be fighting. Yet we nation-build on, bombing Libya, menacing Bashar al-Assad. To many, this role of Middle Eastern policeman is a debauching of our armed forces. And with severe unemployment and addiction at home, why should we keep spending money on a Muslim world that routinely rejects our designs? Trump has effectively linked these two issues by calling for wartime funds to be spent on “internal improvements,” as Henry Clay called them, and many workers have cheered.

This is why I knocked the Wall Street Journal writer Bret Stephens in these pages a couple of weeks ago. Stephens contends that Hillary Clinton must pulverize Trump so that “Republican voters learn their lesson that they cannot nominate a man so manifestly unqualified to be president.” But Trump isn’t primarily a Republican phenomenon, nor is he a lab experiment of the alt-right, as Hillary Clinton suggested last week. He isn’t a product of classifiable politics at all. He’s a howl of rage on behalf of the white working class, who might not agree with him on everything or even think he’s equipped for the White House, but who are tired of failed economic and foreign policies that come at the expense of their livelihoods.

How the white working class puts itself back together again, and where circumstances inflicted on them end and personal irresponsibility begins, are necessary sociological questions, but they won’t be cracked in time to dilute this year’s headline issue, which is that right now many whites are furious and have a consequently cavalier attitude towards their leaders. So Stephens may get his wish and Trump may be demolished on Election Day. Huzzah, but then what? A Trump loss will affect many things, but driving the dope out of Greenfield and assuaging the misery in Appalachia will not be among them.

Matt Purple is the deputy editor of Rare Politics.

Image: Supporters of Donald Trump at a campaign rally in Las Vegas, Nevada. Flickr/Gage Skidmore.