Intentional abuse or misuse of benzodiazepines and opioids in combination increased significantly from 2000 to 2014. Benzodiazepine abuse or misuse far exceeded cases of opioid abuse or misuse. Death was greater with co-abuse or misuse of benzodiazepines and opioids. Population-level campaigns to inform the public about the risk of death with co-abuse or misuse of benzodiazepines and opioids are urgently needed to address this overdose epidemic.

The shift from non-UDP to UDP in over 80% of buprenorphine-naloxone products was associated with a significant decrease in unintentional pediatric exposures reported to poison centers. Packaging controls should be a mainstay in the approach to the prevention of unintentional buprenorphine pediatric exposures as well as exposures to other prescription opioids.

Discussion | During the COVID-19 pandemic in California, older adults, Black and Latino residents, and those without college degrees have experienced the highest per capita excess mortality. Following the statewide shelter-in-place, Latino residents and those without a high school degree/GED had the greatest increase in excess per capita mortality, with rates more than tripling after reopening. We hypothesize that this pattern reflects the risk of COVID-19 death faced by low-wage, essential workers and their social networks owing to occupational exposure, crowded housing, and inadequate access to testing or treatments. 6 Although a limitation of this study is that our analyses were not designed to determine the associations with particular policies, our results suggest that the policies adopted to date have had disparate outcomes across population subgroups. Our findings underscore the importance of examining the inequitable effects of policies during the pandemic, reexamining the effects over time, and investing in strategies to mitigate the excess mortality in affected communities.