About a decade ago, when I was on Ohio’s advisory board that was revising the state’s science standards, there was the big debate over teaching so-called ‘intelligent design’ (ID) in science classes. One of the people attending those meetings was the superintendent of schools in a largely rural district that was in the southern part of the state close to the Ohio river that separates us from Kentucky.

He invited me to speak to all the teachers in their school district about the evolution-ID issue during a day-long conference that he organized for his teachers. The session was to be held on a Saturday morning so I drove down on Friday to Chillicothe, arriving there at about 8:00 pm. It is a small town of about 20,000 so I was taken totally by surprise to suddenly find myself in bumper-to-bumper traffic gridlock that took me about half an hour to go the two blocks to reach my hotel in the small downtown area.

I noticed that the cars were full of young people. When I finally reached my hotel and was checking in, I asked the clerk what was going on and he said that this was just a normal Friday or Saturday night when the young people in the area amused themselves by cruising round and around the few downtown blocks.

The next day I gave my talk to a hall full of teachers about the legal and scientific reasons why evolution should be taught in science classes and ID not taught. It did not go well. Not that they booed me or threw stuff at me. Everyone was nice and polite in that mid-western way but it was clear that I was in Christian Bible country and that my message was falling on deaf ears and that this group was far more comfortable with the story of Adam and Eve than that of natural selection.

During the lunch break, I mingled with the teachers, making the usual small talk asking where they came from and I was struck by the fact that almost all of them seemed to have been born and raised in that same county and gone to the small state university in the adjacent county to get their degrees. When I mentioned this to the superintendent he said that this insularity was a real problem. He found it difficult to get teachers to attend professional development programs outside their areas, even in the state capital of Columbus that was just a couple of hours away, and you could forget about getting them to attend national meetings. This was why he had to bring people like me in.

Having lived a nomadic life that has taken me all over the world, I wondered on my drive back to Cleveland what it must be like to live in a small community all your life where the main social activity of young people was to drive around the same few city blocks week after week. It would have likely driven me crazy but I presumed that people chose to do it and were thus happy.

But maybe not.

The Plain Dealer last week had a disturbing series of stories about how the southern Ohio city of Portsmouth, very close to Chillicothe and similar to it, had a huge problem with widespread addiction to painkilling drugs like oxycontin.

At the half-dozen or so pain clinics in this Appalachian county along the banks of the Ohio River, a handful of licensed doctors pump out prescriptions for an estimated 35 million pain pills a year to an ever-mushrooming population of pill-crazed patients who come from near and far just to cop.

Do the math, and it comes to roughly 460 pills for every man, woman and child in this county of 76,000 residents, according to 2008 state pharmacy board statistics.

It’s gotten so bad that last year the local health commissioner declared a public health emergency, a rare step usually reserved for disease outbreaks.

Lisa Roberts, a city of Portsmouth public-health nurse on the front lines of the epidemic, says locals call it the “attack of the pill heads.” She says a “pharmaceutical atom bomb” has brought the county to the verge of complete social collapse.

Statistics as bleak as tombstones back up Roberts’ apocalyptic talk: The county has seen a 360 percent increase in accidental drug-overdose deaths and has the highest hepatitis C rate in Ohio, a rate that has nearly quadrupled in the past five years, thanks to junkies who are shooting up.

Sixty-four Scioto County babies born in 2009 came into the world with drugs in their system — that’s nearly one in 10 births. And swamped drug treatment centers say they are turning away thousands of locals who need help for prescription-drug addiction.

This story reminded me of the film Winter’s Bone that was nominated for some Academy awards this year. It provides a bleak look at life in the rural areas of the Ozarks in Missouri where addiction to crystal meth seemed to be rampant and destroying lives.

I was wondering if this drug problem was caused by the impact of modernity on communities that were not equipped to handle it. Modern communications now bring the world into every home making them aware of possibilities that are out of reach.

It is one thing for someone to want to get away from it all and choose to live in a rural and remote area, it is another to be born and grow up in it, to feel trapped but fearful of leaving. In a visit last month to rural Georgia to give a talk, I spoke with a young man who had grown up in that small town, gone to college there, and was now working there. He was clearly feeling claustrophobic, dying to get out and move to a big city (Atlanta in his case) but not able to find a way to do so. From my point of view, that region looked very appealing in its quiet and slower-paced way of life. But his frustration and desperation to get out of there was palpable.

It has become popular these days to contrast the alleged decadence of those who live in the big cities and on the densely populated two coasts with those who live in small towns and in rural America. The latter, we are repeatedly told, are the ‘real’ Americans, the ones who represent ‘real’ America and who uphold traditional wholesome values of thrift, temperance, god, patriotism, and morality and that is their voice that should be given priority in the national discussion.

But clearly things are not that simple. My experience in Chillicothe, Winter’s Bone, and the rampant drug addiction problem in Scioto county surely do not represent the lives of all people in rural America. What is true is that the people in these small towns seem to be battling the same demons as people elsewhere and we should abandon the rhetoric of ‘real’ America and ‘real’ Americans. Every part of it is as real as every the other part, with its good and bad.