Ok now I have to share something that's going to be the ace in the hole here. And that is this: I come from Wisconsin. That's right, I'm in the most medieval territory of the midwest, if not the country. And every american who looks up information on wisconsin will find something conspicuous: we are culturally known for drinking. This should shock and disgust people. But that fact is, the association of drinking and Wisconsin has always been with the connotation of legitimacy, and normalcy.
But how do you think it really is here. We have towns where main-street is lined with 30 bars. Everyone I know has been affected by alcohol in some way, whether through dui's, drunken parents or other family, or they are addicts themselves. It is not cultural activity, that you write about on a poster or official website. It's something that people do when the winters get long, and they are bored. And they do it in their houses when it gets down to -20, and their families have no escape
The behavior would generally be rationalized the same way, even here: there would commonly be a denial that there was a problem