On a chilly November morning in North Wilkesboro, N.C., a town of 4,266 in the foothills of the Blue Ridge Mountains, I sit with two young women at the town’s opioid-addiction treatment clinic.

The previous month, President Donald Trump had declared the opioid crisis a public health emergency, six years after the U.S. Centers for Disease Control and Prevention formally declared an opioid epidemic. Since 1999, more than 200,000 Americans have died from prescription opioid overdoses, leading...

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