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I would say it’s very much about personal choices, but not 100%.

1. There used to be a very strong social stigma against making bad life choices. While those stigmas still exist, they have been substantially weakened over the last 60 years by a culture that has become very non-judgmental (unless you are a Trump supporter). If you remove those stigmas, then low IQ people (who have trouble seeing the consequences of their actions to begin with) are more likely to make choices that seem “good” in the short term, but are disastrous in the mid-long term.
2. As you noted, a lot of these family members never even graduated from high school. That in itself is a big strike against you. However, in the past, there used to be factory jobs for these people to take and still make a good living. Obviously, a lot of those factories have closed, moved or been substantially automated. Almost all factory jobs still in the US require technical skills and a HS diploma. Ditto with the Armed Forces.
3. For people without an education, drugs are unfortunately the shortest path to both relief and income.

Re: short term choices.

Part of the problem are are all the unethical Masters of Business Administration being promoted into high positions in business and government.

MBAs are ignorantly educated to look only toward short term gains with the idea that short term gains will trickle up to long term gains. Often that is simply not true. Short term gain myopia always fails because of a failure to plan for Capital investment for future growth; if focuses on the quarterly and yearly bottom lines, but not the five and ten year goals, much less fifty year growth. Research and Development of future products are de-emphasized in preference to marketing current products and services being sold and/or ideas that can quickly be brought to the market, especially those that will redound to the credit of the MBA’s tenure, not to some future management team. One of the secrets to Apple’s repeated successes is their corporate policy of planning for at least five to ten years in the future. That keeps their profits at the highest in the industry.

MBAs are always looking for promotion or teleportation advancement to another position in another management position. To an MBA, management experience, knowledge, and especially loyalty is “fungible,” in their view, and is always transferable; it is not owed to the company they are currently working for. Choices are made always to gild the short term health of their current company because that benefits their CV, not build for the future of that company because they won’t be there. If it harms the employees, so what, the MBA’s résumé is that much better for his next step up the corporate ladder of his/her career building. Ethics does not enter the equation.