In 2021, deaths from drug overdose exceeded 100 000 in the US, a reflection of the rapid increase in the prevalence of illicit synthetic opioids, such as fentanyl and its analogues. Mortality related to fentanyl has surpassed that from prescription opioids and heroin; in 2021, it accounted for 82% of opioid overdose deaths.1 As the opioid epidemic evolves, policies and guidelines should adapt to this new reality. Patients require access to evidence-based and equitable treatment without unnecessary barriers to receiving care.