After watching President Donald Trump target the son of former Vice President Joe Biden for his history of substance abuse, Urban was reminded again of the shame her son lived with during his own battle with addiction.

“I just think that Trump doesn’t understand addiction,” said Urban, 53, a Republican from Delphos, Ohio, who voted for the president in 2016.

The exchange over Hunter Biden’s struggle with addiction was brief, and neither candidate was asked a follow-up question about their plan to tackle the nation’s drug addiction and overdose crisis.

Yet drug addiction continues its grim march across the U.S., having contributed to the deaths of more than 470,000 Americans over the past two decades.

opioid overdose deaths increased again in 2019, topping 50,000 for the first time, according to provisional data from the U.S.

She said what she saw during the debate was “two people yelling at each other,” instead of the substantive policy discussion she believes the issue deserves.

He was active in addressing the opioid crisis early in his administration.

In 2017, Trump became the first president to declare the opioid crisis a national health emergency.

For example, his policies eased access to drugs that are meant to control opioid addiction, especially for people receiving health coverage through Medicaid.

Trump also has repeatedly tried to slash the budget of the drug control policy office, which is intended to set policy for a drug response that is carried out largely by law enforcement and health agencies.

Patrick Kennedy, a Democratic former member of Congress appointed to a bipartisan commission Trump formed to address the opioid epidemic, said the president started in the right direction but did not show up at any of the commission’s meetings or follow up sufficiently.

“This administration has prioritized a very punitive approach to substance use,” said Grant Smith, director of national affairs for the Drug Policy Alliance, “just like previous administrations.”.

The continued stigma is a major obstacle to the nation turning the corner on the opioid crisis, said both Urban and Stewart.

“I applaud Biden for standing up for his son because I feel I’m not afraid to speak about my son’s addiction,” Urban said.