KELLY MCEVERS, HOST:
When he was running for president, Donald Trump talked about the country's opioid epidemic.
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PRESIDENT DONALD TRUMP: As I campaign across this country, I hear so many stories and pleas from women especially about drug addiction and opioid use.
MCEVERS: This week, he repeated a promise to deal with the epidemic. We're going to hear from two families who know a lot about addiction. They are watching closely to see what President Trump will do. NPR's Sarah McCammon reports.
SARAH MCCAMMON, BYLINE: Cary Dixon has been speaking publicly about addiction for several years. Last year, then-President Obama invited her to join him at an event in Charleston, W.Va., focused on the growing opioid epidemic. She told him about the toll addiction can take on everyone in a family.
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CARY DIXON: We neglect our marriages. We neglect other children in our home who are thriving because all of our attention is focused on addiction and substance abuse.
MCCAMMON: Dixon's 29-year-old son has been fighting opioid addiction for years, maybe even since high school. At first, Dixon says it was hard to know how to help her son through several rounds of treatment and incarceration.
DIXON: It's kind of like you're on a parallel track with them. You wait for the next crisis. You wait for the next phone call. You're upset when you don't get a phone call. You're just - you're desperate.
MCCAMMON: Dixon is 52 and a former nurse who now runs a business with her husband. They live in Huntington, W.Va., one of the cities hardest hit by the opioid epidemic in a state with the nation's highest rate of addiction-related deaths. Sitting by her crackling fireplace, Dixon says she voted for Democratic nominee Hillary Clinton, and she's worried about President Trump's talk of repealing Obamacare. She's especially concerned about preserving coverage for drug and alcohol treatment.
DIXON: I know that the Affordable Care Act needs tweaked, but to be repealed and to lose the gains that we've made would be harder on our community. You know, we're trying to dig out of this hole anyway.
MCCAMMON: West Virginia expanded Medicaid under the ACA. More than 200,000 West Virginians have been added to the public insurance roles - a big number in a state with less than 2 million people. Dixon's friend Bob Hardin shares her concern. They met through a support group for family members. His son has struggled with alcoholism for decades. Hardin has mixed feelings about the ACA, but he worries about any change to federal policy that would take away access to addiction treatment.
BOB HARDIN: It works sometimes, but sometimes it doesn't. But that's - at least it's there. It's like you get a wound in your arm, you've got a hospital to go to. You get sewed up. You've got a better chance of that wound healing if you have something to go to like that.
MCCAMMON: Hardin, who's 73, wrote in Republican Governor John Kasich of Ohio on his ballot in November, but he hopes Trump can work with Congress to deliver on his promise to put more Americans back to work. Hardin thinks more jobs might help people here keep busy and off of drugs and alcohol. Hardin spent years working in Baltimore before returning to Huntington, and he's seen West Virginia's coal-dependent economies shrink while the opioid epidemic has grown.
HARDIN: The change is phenomenal, though, from when I left here and when I came back. And it's a tough place to get a job.
MCCAMMON: President Trump has also promised to stem the flow of opioids into the U.S. by building a wall along the U.S.-Mexico border. Both Hardin and Dixon are skeptical of that idea.
DIXON: A wall is not going to stop them from doing what they do, and if you build a wall, they will adapt.
MCCAMMON: Dixon says West Virginia will be looking to the Trump administration for practical things, like more beds in drug treatment facilities to help people like her son. Sarah McCammon, NPR News.
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