CHARLESTON, W.Va. (AP) — West Virginians on Tuesday will choose between a Republican candidate for governor endorsed by former President Donald Trump who has defended abortion restrictions in court and a Democratic mayor who has fought to put the issue on the ballot for voters to decide.

Both Attorney General Patrick Morrisey and Huntington Mayor Steve Williams have played an outsized role in fighting the drug crisis in the state with the highest rate of opioid overdose deaths in the country. But their similarities are few.

When it comes to abortion, the two couldn’t be more different.

Since he was elected attorney general in 2012, Morrisey, 56, has led litigation against opioid manufacturers and distributors netting around $1 billion to abate the crisis that has led to 6,000 children living in foster care in a state of around 1.8 million.

A self-described “conservative fighter,” Morrisey has also used his role to lead on issues important to the national GOP. Those include defending a law preventing transgender youth from participating in sports and a scholarship program passed by lawmakers that would incentivize parents to pull their kids from traditional public school and enroll them in private education or homeschooling.

Key to his candidacy has been his role in defending a near-total ban on abortions passed by the Republican-controlled legislature in 2022 and going to court to restrict West Virginians’ access to abortion pills.

In a statement after a U.S. District Court judge blocked access to abortion pills in 2023, Morrisey vowed to “always stand strong for the life of the unborn.”

Former Huntington city manager and House of Delegates member Williams, 60, has worked to change his city from the “epicenter of the heroin epidemic in America” to one known for solutions to help people with substance use disorder.

After being elected mayor in 2012, he instituted the state’s first citywide office of drug control policy and created a strategic plan that involved equipping first responders with the opioid overdose reversal drug Naloxone and implementing court diversion programs for sex workers and people who use drugs.

Abortion has been a key part of his campaign platform. Earlier this year, Williams collected thousands of signatures on a petition to push lawmakers to vote to put abortion on the ballot.

West Virginia is among the 25 states that do not allow citizen initiatives or constitutional amendments on a statewide ballot, an avenue of direct democracy that has allowed voters to circumvent their legislatures and preserve abortion and other reproductive rights in several states over the past two years.

Republicans have repeatedly dismissed the idea of placing an abortion-rights measure before voters, which in West Virginia is a step only lawmakers can take.

Republican leadership has pointed to a 2018 vote in which just under 52% of voters supported a constitutional amendment saying there is no right to abortion access in the state. But Williams said the vote also had to do with state funding of abortion, which someone could oppose without wanting access completely eliminated.

If elected, Morrisey would become just the third Republican elected to a first gubernatorial term in West Virginia since 1928. Outgoing two-term governor Jim Justice, now a Republican, was first elected as a Democrat in 2016. He switched parties months later at a Trump rally.

Polls statewide open at 6:30 a.m. and close at 7:30 p.m.