The latest count from the Centers for Disease Control and Prevention (CDC) went up to 93,000 deaths in 2020, an increase of 29 percent over the previous year. Disparities between different population groups widened: black people 15-24 years old experienced the largest rate increase, 86 percent, seven times that of white men in the same age group; overdose rates for American Indian/Alaska Native (AI/AN) women 25-44 years were nearly two-times that of white women. Surprisingly, overdose rates in 2020 were higher in areas with higher availability of opioid treatment programs, particularly among black and AI/AN people. The known differences in access, barriers to care, and health care mistrust could play a role in exacerbating inequities even when treatment is available in the community. Rural-urban data cuts were not included in this study.