> Junkies shooting up in public, homeless people shitting on the sidewalk, etc, etc is a problem confined to a handful of cities on the west coast.
This just isn't true. At all. This is a problem in cities all over the country. Some cities hide it away, but homelessness and the other problems that come with drug addiction exist all across this country.
I live in Portland so I'm well aware of the effects from a large homeless population, but I try to travel as often as I can and I make it a point to get out of tourist areas as much as possible, usually to concerts or something. I can tell you first hand, within the last 2 years Philadelphia seems to have the same issues, DC definitely has the same problems, Boston, NY, Chicago, Austin, and Denver all have visible homeless.
What I find strange is how every city tends to believe their city is unique with homeless, like they don't realize this is a problem across the entire country. Go to any of those city's subreddits and search "homeless" and you'll see how they've all deluded themselves into believing their city is somehow unique and magically the only place in the country with a homeless problem. It's bonkers. This is a massive problem across the entire country. I suspect small towns across the rust belt probably have their own problems, especially considering how their meth and opiate addictions on a per capita level are significantly higher than even major cities.