Like live in a town with a very high number of rehabs, one of the highest in the US. A lot of these rehabs are run by addicts and alcoholics. Sometimes they have very little time sober, but can buy a house to set up as a rehab/sober living. There isn't a whole lot of education required to start one, either. There is no requirement for the treatment plan to be science-based or evidence-based, either. Most are quasi-religious, in the AA "higher power" sense, and a bunch are flat-out Christian rehabs.

Honestly, addiction is a difficult problem. A lot if the time it's good for people with similar problems to get together and work towards a solution. It's not always easy to tell who's a good actor. For example, some rehabs take mostly indigent low-bottom drinks from off the street. I'd imagine that they have a much higher rate of relapse just from the population.

Ultimately I think it's tied in to a lot of similar social problems, like poverty, mental health, homelessness and prison issues. In general, the US just doesn't value improving those things very much. Which is sad.