I'm just a data point, but I lost 12 friends before I was aged 20. This was in the rust belt during the 90s. The reasons ranged across the board: opioids, crack

I'm just a data point, but I lost 12 friends before I was aged 20. This was in the rust belt during the 90s. The reasons ranged across the board: opioids, crack, alcohol, cancer, preventative health conditions, accidents, and suicides. I was always amazed that people didn't report on this kind of stuff back then. But, all of my friends were poor.