I can attest that disability is a way of life in certain parts of the country. $15k/year may not sound like a lot, and it objectively isn't, but a household of 2 adults and 0-2 kids pulling $30k/year in some parts of the country can actually get by pretty well. If you can get an extra $10-20k/year in free opiates that's either a great way to feed an addiction or to make money on the side. There are counties where almost half of the adult population is on some kind of disability and those also happen to be the counties hurt hardest by the opiate epidemic, and known for "pain clinics".

But, I think there is a third part of the cycle that the article you linked mentions. Nobody grows up wanting to survive off disability and being an opiate addict - while the pain clinic/disability combo might enable people entering this state, the reason people give in to this is that they have poor life prospects. Going on disability is basically giving up. We need to figure out how to provide better job and educational prospects in the areas / for the kind of people who are incentivized to go on disability so that they actually have much better options. The average West Virginian isn't intrinsically less able than the average resident of Utah