In 2016, Wilmington, NC had the highest concentration of opioid use disorder among US cities. Community leaders including regional health system chief physician executive Philip M. Brown, MD, FACS helped intervene in this public health epidemic. Brown describes the moment a national report triggered awareness of the local opioid epidemic. He and his fellow leaders undertook multi-faceted interventions to change prescribing habits, impact social determinants and, most importantly, de-stigmatize addiction.