What are the features of the culture and family Vance comes from that create "a family and culture in crisis"?

In Hillbilly Elegy, Vance deals with numerous circumstances that contribute to the status of a "family and culture in crisis." These include poverty, drug addiction/exposure, and familial instability. Vance describes the area of his upbringing as poor and consisting of a largely uneducated population. The economic status of his family and the lack of educational opportunity are two of the main "features" that are responsible for the depressed nature of his circle of friends and family, though, even seemingly in Vance's opinion, that is an oversimplification. He tells the story of a local company (tile manufacturing) that had difficulty hiring dedicated workers for their stable jobs. It seems that a certain amount of apathy on the part of many in the area was just as much to blame for poverty as any perceived lack of employment.
However, the most consistent, and detrimental, feature in the book appears to be a wide use and acceptance of narcotics in Appalachia, a habit that statistically lends itself to the type of hindered environment Vance describes.
Vance also identifies a tendency among the denizens of Appalachia to solve problems outside the confines of due legal process. Examples he includes are that of a man being murdered (before legal justice could be applied) because he was accused of rape and another (though unconfirmed) story of a member of his inner circle who was rumored to have shot a man and held him at gunpoint for attempting to steal the family's cow.
All of these elements (poverty, lack of education, limited work ethic, narcotics, and an eagerness to operate outside of the law) contribute to Vance's heart-wrenching portrayal of his upbringing and ultimately lead to the crisis he writes about.