In a town hall televised by MSNBC Monday night, Sen. Bernie Sanders called out the pharmaceutical industry for pumping addictive opioids into small, rural towns—parts of the country already devastated by disappearing jobs and crumbling infrastructure.

“I’ve got to tell you, I’m not a great fan of the pharmaceutical industry in general,” Sanders said, according to the Bluefield Daily Telegraph. “For them to make to make billions in profits by getting young people addicted and ruining their lives … we have to start holding them accountable.”

The event was held in McDowell County, West Virginia, which has one of the highest per capita fatal drug overdose rates in the country. Not by coincidence, West Virginia coal country was the target of a concerted push by the pharmaceutical industry to bring addictive painkillers to poor, rural regions.

In December, the Charleston Gazette-Mail reported that out-of-state pharmaceutical companies went to extreme lengths to sell drugs in West Virginia, including McDowell County. In one case, just one pharmacy in a town of 392 received 9 million hydrocodone pills over the course of two years.

“In six years, drug wholesalers showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers,” the investigation found. “The unfettered shipments amount to 433 pain pills for every man, woman and child in West Virginia.”