The effect of lifting eviction moratoria on fatal drug overdoses in the context of the COVID-19 pandemic in the US

Between May 2020 and December 2021, there were 159 872 drug overdose deaths in the United States. Higher eviction rates have been associated with higher overdose mortality. Amid the economic turmoil caused by the COVID-19 pandemic, 43 states and Washington, DC, implemented eviction moratoria of varying durations. These moratoria reduced eviction filing rates, but their impact on fatal drug overdoses remains unexplored. We evaluated the effect of these policies on county-level overdose death rates by focusing on the dates the state eviction moratoria were lifted. We obtained mortality data from the National Center for Health Statistics (NCHS) and eviction moratoria dates from the COVID-19 US State Policy Database. We employed a longitudinal targeted minimum-loss-based estimation with Super Learner to flexibly estimate the average treatment effect of never lifting the moratoria. Lifting state eviction moratoria was associated with a 0.14 per 100 000 higher rate of monthly overdose mortality (95% CI, -0.03 to 0.32), although confidence intervals were wide and included zero. Eviction moratoria may not be sufficient to prevent overdose mortality during crises such as the COVID-19 pandemic.