COLUMBUS, Ohio (AP) — Like millions of Americans, Diane Urban watched the first presidential debate last month at home with her family. When it was over, she turned off the television and climbed into the bed her 25-year-old son Jordan used to sleep in.
It was where she found Jordan's lifeless body after he overdosed on the opioid fentanyl one morning in April 2019.
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.
Though Biden's campaign has a policy paper on addiction, the issue has barely registered in this year's presidential campaign, overshadowed by the human and economic toll of the coronavirus outbreak and the Trump administration's response to the pandemic. 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.
And it's only getting worse.
After a one-year drop in 2018, U.S. opioid overdose deaths increased again in 2019, topping 50,000 for the first time, according to provisional data from the U.S. Centers for Disease Control and Prevention. That accounted for the majority of the 71,000 fatal overdoses from all drugs. While national data isn't available for most of 2020, The Associated Press surveyed individual states that are reporting overdoses and found more drug-related deaths amid the coronavirus pandemic.
Ohio, a battleground state in the presidential contest, is on track to have one of its deadliest years of opioid drug overdoses. More residents died of overdoses in May than in any month in at least 14 years, according to preliminary mortality statistics from the state health department.
As Trump nears the end of his first term, some supporters, including Urban, feel left behind by his administration's drug policies.
During Trump's first two years in office, 48 of the 59 Ohio counties with reliable data saw their overdose death rates get worse, according to an analysis of CDC data by The Associated Press. The data was compared to overdose death rates in 2015 and 2016, the last two years of the Obama administration.
What that looks like on the ground is mothers donating to GoFundMe accounts and Facebook campaigns so other mothers can bury their children who've overdosed. Some parents even reserve a casket while their child is still alive so they are prepared for what they believe is inevitable.
Others become legal guardians of their grandchildren. Among them are Brenda Stewart, 62, and her husband, who adopted their grandchildren a decade ago as their son struggled with addiction. That led Stewart to start The Addict's Parents United, a non-political support group for parents of children with the disease or who have lost a child to it.
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.
"I feel there needs to be more discussion about this disease on a national stage," said Stewart, who lives in Columbus, the Ohio state capital. "Kids are dying here every day. I have mothers and fathers losing children almost daily. "
The longtime Republican said she plans to vote for Trump again, but also notes that this disease has no political bias and that it can touch anyone.