How does exposure to the opioid crisis affect public opinion about drug policy? I use numerous public opinion surveys to test the relationship between state and county exposure to the opioid crisis and support for public health or criminal justice-oriented approaches to drug policy. Next, I use two Massachusetts ballot questions to test how local overdose death rates predict support for marijuana legalization over time. I find that there is no clear evidence of a strong relationship between the local context of the opioid crisis and an individual’s support for public health or punitive drug policies. I also find evidence that state context predicts perceptions that the opioid crisis is severe and that politicians should prioritize it. Despite being a nationally salient issue with high local variation, local context does not appear to be a major factor in public opinion about the opioid crisis.