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JUANA SUMMERS, HOST:

America's opioid crisis has resurfaced as a political issue ahead of the midterm elections. Many Republicans are talking about opioids and fentanyl not as a public health problem but as a symptom of what they describe as a crime and border crisis. As NPR addiction correspondent Brian Mann reports, that worries some drug policy experts.

BRIAN MANN, BYLINE: On an autumn evening, Ryan Hampton stands in front of a crowd in Spokane, Wash.

RYAN HAMPTON: You see these overdose numbers hitting new historic highs.

MANN: Hampton's an activist who was addicted to opioids for years. Now he's traveling the country in a big bus ahead of the midterm election, holding rallies, trying to put the drug crisis back in the spotlight of American politics.

HAMPTON: How many in this room are a voter? If you're a voter, raise your hand. All right. Good, good, good. If you're not...

MANN: Drug deaths have surged horribly in recent years, driven by the rapid spread of illicit fentanyl, the super powerful synthetic opioid. Despite the carnage, Hampton believes this public health emergency has been eclipsed.

HAMPTON: COVID did step in front of the overdose crisis and the addiction crisis in this country.

MANN: So barnstorming the country, Hampton's goal was to spread a hopeful message that this drug crisis is solvable. It's a health care issue, he says, one voters should care about and politicians should spend money to fix. But Hampton worries the debate over drugs is being reframed instead by fear and partisanship.

HAMPTON: Some of the rhetoric that we're hearing is not helpful. It actually, you know, endangers us, maybe.

MANN: A bit of history. In recent years, drug and addiction policy has been remarkably bipartisan. Both parties deemphasized drug war-era strategies like police and prisons, focusing more on things like treatment and housing. But now, Republicans are hitting Democrats with attack ads like this one.

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UNIDENTIFIED PERSON: John Fetterman supports decriminalizing dangerous drugs like fentanyl and heroin.

MANN: Mehmet Oz, the Republican in the Pennsylvania Senate race, is accusing Democrat John Fetterman of being weak on drugs and crime.

(SOUNDBITE OF POLITICAL AD)

UNIDENTIFIED PERSON: And Fetterman supports creating heroin injection sites in our neighborhoods.

MEHMET OZ: Fetterman's ideas are radical, deadly and wrong.

MANN: There are some real policy differences here. Fetterman, the Democrat, has called for decriminalizing drugs, focusing instead on a health care response. So he's backed away from that position during this campaign. He's also supported supervised drug use sites. They're controversial, but some studies show they help reduce fatal overdoses. Here's Fetterman speaking on a podcast in 2018.

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JOHN FETTERMAN: I think it's important that we as a society have all the options on the table, including needle exchange and even safe injection sites that are being considered like, say, in Philadelphia.

MANN: The real-world stakes in this drug policy debate are incredibly high. Fentanyl has emerged as one of the top killers of young Americans, far more deadly than COVID or guns. Black and Native Americans have also been hit hard. Jessica Taylor thinks the Republican reframing of addiction as a crime issue worsened by Democratic policies may prove effective.

JESSICA TAYLOR: It's certainly a rising issue, and I think it's one that Republicans believe they have an advantage on. And that very well may bear out.

MANN: Taylor analyzes Senate races for the Cook Political Report. She says by raising fears about drugs and crime, Republicans hope to eclipse voter concerns about more Democrat-friendly issues like abortion.

TAYLOR: I think this is really aimed to sort of getting back wayward suburban voters that the party saw eroding, particularly women.

MANN: Taylor says polls suggest this narrative has helped tilt some close races toward Republican candidates who've also linked the drug issue to border security. In Ohio, Republican Senate candidate J.D. Vance has echoed a right-wing conspiracy theory that Democrats are deliberately allowing Mexican drug cartels to smuggle fentanyl into the U.S. Here's an interview Vance gave in April to the right-wing outlet Gateway Pundit.

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J D VANCE: If you wanted to kill a bunch of MAGA voters in the middle of the heartland, how better than to target them and their kids with this deadly fentanyl? And, man, it does look intentional.

MANN: This isn't factual. Efforts to target the drug cartels inside Mexico actually collapsed during the Trump administration. Over the last two years, the Biden administration has scrambled, most experts say without much success, to reduce the flow of fentanyl into the U.S. Still, Democrats clearly worry about looking soft on this issue. In a Senate debate last week, Ohio Democrat Tim Ryan echoed Republican ideas about stopping fentanyl traffickers.

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TIM RYAN: A stronger border, more Border Patrol. I disagree with President Biden when he's talking about...

MANN: Some Democrats have also embraced a Republican proposal that fentanyl be officially designated a weapon of mass destruction, an idea the Biden administration has rejected. Ryan Hampton, the activist who's been traveling the country pushing for a health care response to addiction, worries the GOP's reframing of the drug debate will continue beyond the midterms. He thinks it's already driving a fentanyl crackdown, meaning more focus on prisons, less money for treatment.

HAMPTON: When we start to weaponize one particular drug, such as fentanyl, we also weaponize the response and militarize the response. We have seen this playbook before with crack cocaine, and we saw the devastating results of that.

MANN: But with overdoses surging and more people seeing family and friends die, some voters may welcome Republicans' promise to get tough on fentanyl.

Brian Mann, NPR News. Transcript provided by NPR, Copyright NPR.

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