Although anecdotal reports suggest that many religious communities in the United States oppose public health policies such as medication-assisted treatment and syringe services, the relation between religiosity and drug policy attitudes is currently unclear. A survey of support for protective and punitive drug policies was conducted with 3,096 residents from 14 Appalachian and midwestern states currently affected by the rural opioid epidemic. Despite the high prevalence of drug use in the sample, only 59% and 36% of the respondents, respectively, supported medication-assisted treatment and syringe exchange services, and 52% and 50%, respectively, supported punishment and incarceration for people who use drugs. Furthermore, although religious affiliation had no association with personal support for either protective or punitive drug policies, the frequency of religious service attendance was positively correlated with support for punitive policies and negatively correlated with support for protective policies. In addition, the perception of punitive norms among religious leaders was positively correlated with personal support for punitive policies, and the perception of protective norms among religious leaders was positively correlated with personal support for protective policies. Thus, religious attendance and religious norms may reduce compassion toward others in the context of the rural drug use epidemic in the United States.