From the bustling streets of Philadelphia to the rural farmlands of Mercer County, nearly every community in Pennsylvania has been rocked by the opioid crisis – and the problem keeps worsening.

In 2016, more than 4,600 Pennsylvanians died as a result of drug abuse. It has affected the lives of thousands more.

Jose Benitez, the executive director of a needle exchange clinic in Philadelphia, struggles to make sure he has enough manpower and resources to treat his growing number of patients. He said three years ago, he treated 4,000 patients. Now, he serves about 15,000, most of whom are battling opioid-related addictions.

“We have mothers, fathers, sister, brothers dying daily,” he said. “It has to stop.”

For Benitez, additional funding and attention to the opioid crisis is a tipping point in the Pennsylvania midterm election. He hopes to see lawmakers who are educated on addiction and can provide innovative solutions.

“What we’ve done so far isn’t working,” Benitez said. “In Kensington [Philadelphia], we have more than 600 homeless people, most of them addicted to opioids. It’s a real public health issue and it’s devastating our communities.”

The opioid problem is emerging as a major issue during the midterm elections, particularly in areas hard hit by the growing crisis.

“This is an issue that voters on the ground care about,” said Jeanne Zaino, a political science professor at Iona College in New Rochelle, N.Y. “Look at the Wisconsin Senate race, for example, where healthcare has been a major issue leading up to the midterm.”

A recent analysis by the Wall Street Journal shows that ads mentioning the opioid crisis have aired more than 50,000 times in congressional and gubernatorial races across 25 states. Just four years ago, at around this time, it had only been mentioned 70 times, the Journal reported.

The Wisconsin Senate race is one of several where candidates have feuded over how to address the opioid epidemic. Democrats in the state have hammered away at Republican candidate Leah Vukmir's legislative health care record, claiming she sides with insurance companies and businesses over ordinary Wisconsinites. Republicans say a government-run system will not only divert treatment but decrease the quality of care for everyone.

It is also a major problem in Pennsylvania’s largest county, Philadelphia, where more than 1,217 drug-related deaths were reported last year.

The Democratic candidate for Congress in Lehigh Valley, Susan Wild, wants to focus on medical care – not criminal prosecutions. Her Republican opponent, Marty Nothstein, thinks the focus should be on public safety. Nothstein believes beefed up border security will help cut off the influx of what he calls replacement drugs – like fentanyl and heroin – that have contributed to fatalities both regionally and nationally.

In northeast Pennsylvania, the opioid crisis has become a political focal point. Incumbent Rep. Tom Marino, R-Cogan Station, was nearly named America's drug czar, under the Trump administration, but withdrew his name after he was accused of weakening laws that favored the pharmaceutical industry.

Marino, a former federal prosecutor, has called the allegations a “hatchet job.” Nonetheless, has been criticized by his Democratic opponent, Marc Friedenberg, who claims Marino is too cozy with drug companies to make a real dent on the opioid crisis.

“Throughout my campaign, this crisis has been one of the most common issues that voters want to talk about,” Friedenberg said in a recent statement. “We need real solutions; we don’t need politicians like Tom Marino who are more interested in cashing checks from Big Pharma than they are in helping Pennsylvanians.”

Friedenberg held an “opioid town hall” last month. This past summer, Marino also held a town hall focusing on the opioid crisis that was co-hosted by celebrity Dr. Phil.

Marino has defended his record, saying as a prosecutor he has dedicated his life to “aggressive and faithful enforcement” of the nation’s laws.

“Given my lifelong devotion to law enforcement, I insist on correcting the record regarding the false accusations and unfair reporting to which I have been subjected," Marino said when the allegations first arose.

Zaino believes the current drug crisis can become the deciding factor in many toss-up races in the northeast. Combating the opioid epidemic is a shared viewpoint, Zaino said, essentially no one opposes it – but candidates do differ on how to address the issue.

“When you remove healthcare coverage from the conversation, the likelihood of someone accessing treatment significantly decreases,” said Democratic Strategist Roger Fisk. “So, Republicans are really at odds with themselves on this issue. You can’t fight the epidemic and cancel coverage at the time.”

Republicans, on the other hand, would like to see a shared effort between the private and public sector as well as emphasizing law enforcement’s role in cutting off the flow of illicit drugs.

“This issue is about making America strong again, the community along with lawmakers have to forge an alliance and work together to repair our communities,” said Republican strategist Chris Prudhome.

Despite the differences, the topic has remained a priority for lawmakers. Last week, Congress approved a rare bipartisan bill to combat the growing health crisis – creating, expanding and reauthorizing drug programs and policies across almost every federal agency.

The bill was sent to the White House just in time for lawmakers to campaign on the issue before the November midterm elections.

“It will be interesting to see how voters in the Northeast, where there are Republicans and Democrats running on this issue with two different viewpoints, vote,” said Zaino, “I think only the exit polls will tell us what Americans want to see happen next.” ​​​​​​