Before the COVID-19 pandemic, the United States was already seeing staggering numbers of drug overdose deaths, with over 70,000 people dying from an overdose in 2019. When the pandemic began in early 2020, in-person health care visits presented significant risk for COVID-19 infection and spread. Federal agencies took swift action to create sweeping, yet temporary, regulatory changes to opioid use disorder (OUD) treatment policy so that patients could maintain uninterrupted access to health care. Since the onset of the pandemic, racial disparities in overdose prevalence have widened in the state, with overdose deaths among Black people outpacing other racial groups in California. Statewide, counties including San Francisco, Los Angeles, and San Diego are facing unprecedented increases in overdose-related morbidity and mortality, in part due to the rise of illicitly manufactured fentanyl. Because both the COVID-19 pandemic and the overdose crisis have evolved in the past two years, re-examination of the role of addiction treatment in reducing opioid-associated morbidity and mortality and promoting health equity is needed.
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