It’s not surprising that there’s so much drug use in towns where there’s so little to do. But the root of this kind of addiction crisis is social isolation. Addiction is a disease that afflicts the lonely. It is a disease that afflicts those who have suffered trauma in childhood and beyond. And once the social fabric frays it’s hard for economic recovery to begin. I ran into employers in Pittsburgh who had industrial jobs to fill but they couldn’t find people who could pass the pre-employment drug test.

Clinton did gesture toward some of these truths, saying, “They’re dying from suicide, but I thought Bill really put his finger on it. He said, ‘You know what they’re really dying of? They’re dying of a broken heart.’” But her policy ideas don’t exactly respond to current realities.

She vowed to “take a hard look at retraining programs.” She’d expand tax credits to encourage investment. She’d get tough on trading partners who are trying to dump cheap steel. These are the normal, sensible ideas candidates propose, but they are familiar and haven’t exactly done much good.

A daring approach might have been to use the speech to propose a comprehensive drug addiction and mental health agenda. That would have grabbed the attention of all those Americans whose families are touched by addiction and mental health issues — which is basically everybody.