In 2018, drug overdose was a top cause of overall mortality in the United States, killing more than 67 300 Americans, with 46 802 of these deaths involving opioids. In the midst of this opioid epidemic, the health care system is restructuring in major ways to prevent and treat coronavirus disease 2019 (COVID-19), which has already caused more than 80 000 deaths in the United States. Early popular press reports suggest the pandemic may be associated with increased opioid overdose rates in certain communities. Although the opioid-associated effects of the pandemic have not yet been formally measured, this necessary restructuring may directly increase the risk of poor outcomes for patients who have opioid use disorder (OUD) with and without COVID-19 infection. Proactive policy and public health efforts are necessary to ensure equitable treatment of those who become infected and mitigate opioid-associated risk for those who do not.
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