This chapter examines the long-term consequences of media framingMedia framing on public policy responses to addiction, focusing on the contrasting narratives of the heroin epidemicHeroin epidemic of the 1970s and the opioid crisisOpioid crisis of the twenty-first century. Through historical and comparative analysis, it reveals how racialized media portrayals that criminalized Black and Latino heroin users while medicalizing White opioid users shaped legislative outcomes, funding priorities, and public sympathy. The chapter traces how punitive drug laws, such as mandatoryMandatory sentencing minimum sentencing and the expansion of the carceral stateCarceral state, were fueled by fear-based reporting during the heroin era. In contrast, empathetic opioid coverage led to health-centered policy reforms, including the Comprehensive Addiction and Recovery Act and the SUPPORT Act. Yet, the benefits of these reforms were not equitably distributed. The chapter argues that policy is not only evidence-driven but also narrative-driven, and the stories media tell play a decisive role in shaping who is punished, who is treated, and who is left behind. It concludes with a call for media accountability and structural equity in addiction policyAddiction policy, setting the stage for the final chapter’s focus on ethical journalism.