Vermont Senator Bernie Sanders said addiction is a “disease not a criminal activity” during a discussion on America’s heroin epidemic during Saturday night’s Democratic debate.

The debate took a somber turn when the candidates addressed the high levels of heroin and opioid use across the country. According to the Centers of Disease Control and Prevention, the rate of heroin-related overdose deaths have quadrupled between 2002 and 2013. The Senator’s home state of Vermont has been hit particularly hard by heroin addiction, with the governor calling it a “full-blown crisis” in 2014.

Read More: Democrats Clash in Final Debate of 2015

On Saturday, Sanders said the epidemic calls for a “radical” change in the approach to addiction in America, saying the health care community needs to “get its act together” when both prescribing opioids and addressing issues of mental health and addiction.

Candidates Hillary Clinton and Martin O’Malley also touched on the issue. The former Secretary of State said she’s addressed the issue in town halls and laid out a “five point plan” on how to better handle the crisis.

O’Malley recalled overdoses of close family friends and his experience with heroin given his former position as mayor of Baltimore, which has often been called a “heroin capital” of the U.S.

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