Warren outlined her idea to tax the wealthiest Americans and deliver sorely needed funding directly to hard-hit communities.
The Massachusetts senator is proposing to spend $100 billion over 10 years on battling addiction. Her plan is for a 2% tax on those making $50 million or more "so everybody else has a chance to make it."
"I'm tired of freeloading billionaires," Warren said to loud applause from a crowd of about 150 people at the volunteer fire station in Kermit along the Kentucky border.
Among those listening intently were Kermit physician Dr. J.W. Endicott and town Fire Chief Tommy Preece, who lost a brother to a drug overdose.
Preece said he was surprised Warren chose to visit Kermit because "she's coming right into the middle of Trump country."
Endicott, whose biggest frustration as a physician in a rural area is not having enough drug treatment facilities, said Warren's message "is a big deal for us, a big deal nationally."
Warren said her proposal would bypass state governments and send federal funding directly to communities whose leaders would determine how it is used.
"The money needs to be here in Kermit and in towns and on reservations across this nation that are on the front lines in the battle," Warren said. "We don't need it tangled up in more politics. We need this money to go straight to the people who are dealing with the crisis every hour of every day."
Marybeth Beller, an associate professor of political science at Marshall University, said Warren's policies resonate with West Virginians, who "really have a history of liking hands-on politicians that will come out and meet them and talk to them and listen to them."
Beller said it may be too early to count West Virginia as a solid red state.
"In '16, a lot of people put hope into Donald Trump because of his rhetoric," she said. "I think measuring that two-and-a-half years later, particularly with coal jobs, it just hasn't come to fruition. So, do I think that West Virginia could change back to blue? I think so."
Kermit is located along the Tug Fork in Mingo County, which dubs itself "The Heart of the Billion-Dollar Coalfield." But West Virginia continues to be one of the poorest states in the nation, ranking 49th in per capita income, and is among those to lose thousands of jobs in the coal industry's downturn this century.
Mingo County's coal employment dropped from 1,750 jobs in 1997 to 764 last year, while production fell from 22.4 million tons to 5.1 million over the same period.
As the jobs have left, so too have the people. West Virginia's population has dipped every year since reaching 1.86 million in 2012.
Warren, who also had scheduled stops later Friday in Chillicothe and Columbus, Ohio, spoke a few blocks from a now-closed pharmacy in Kermit where wholesale drug distributor McKesson Corp. shipped an average of 9,650 hydrocodone pills per day in 2007. A decade later, the town of 360 people fought back, suing McKesson and four other drug wholesalers, saying they illegally flooded Kermit with millions of prescription pills.
The lawsuit, one of many filed by municipalities throughout the state against drug distributors, seeks to recoup the costs of dealing with opioid abuse.
Last week the state announced a $37 million settlement in its lawsuit against San Francisco-based McKesson. Democrats, including U.S. Sen. Joe Manchin of West Virginia, say the settlement was minuscule compared to the harm inflicted on West Virginians.
In 2017, Preece's brother, assistant Kermit fire chief Timmy Dale Preece, died of an overdose. Timmy Preece had been taking medication to help deal with the pain from a broken neck.
Tommy Preece, a Democrat, is open to Warren's proposal because he believes the opioid crisis needs America's fullest attention, especially in the two counties his department serves.
"It's bad, it really is," Preece said. "We have a lot of young kids in our community and we don't want to see them go down this route."
The scope of the epidemic predates their generation. Preece's father, the late fire chief Wig Preece, was convicted in the 1980s of selling marijuana, pills and other drugs from a trailer parked near the Kermit town hall and police station. A sign posted on the trailer at one point by the elder Preece read, "Out of drugs, back in 15 minutes."
Wig Preece's wife, six of their 14 children and their son-in-law, Police Chief David Ramey, also were sentenced to lengthy prison terms.
Associated Press writer Anthony Izaguirre in Charleston contributed to this report.