Opioid addiction and abuse has become a nationwide epidemic in America. Chief among the states where this behavior is most pervasive is North Carolina. Current statistics reveal that not only are addiction, abuse, and untimely deaths owing to overdose (especially from heroin use) are found in urban areas, but these behaviors are also pervasive in rural areas of the state where health experts and criminal justice officials struggle with the challenges of addressing public health and criminal justice consequences that come with drug addiction and abuse such as treatment, prevention, and punishments, respectively. Unlike urban areas that often have adequate resources to address these concerns, this is not the case in rural areas that struggle with more addicts and offenders than resources to manage this current crisis. Because of the complexity of the opioid crisis and many of the past lessons learned from the crack cocaine epidemic of the 1980s, we believe that society can more effectively address the new opioid epidemic by relying on both criminal justice as well as public health strategies.