This report examines OUD prevalence rates and the association between OUD and key social outcomes for Department of Social and Health Services (DSHS) clients aged 18 to 64 in State Fiscal Year 2022. Outcomes are presented for persons served by the DSHS Aging and Long-term Support Administration (ALTSA), Behavioral Health Administration (BHA), Developmental Disabilities Administration (DDA), Economic Services Administration (ESA), and Division of Vocational Rehabilitation (DVR). The risk that an individual develops an opioid use disorder (OUD) that would increase their risk of overdose is related to biological, environmental, genetic, and psychosocial factors. Although OUD occurs in individuals from all socioeconomic backgrounds, OUD risk is related to poverty, and therefore related to factors that affect the distribution of income and wealth across communities, including but not limited to the impact of structural and interpersonal racism on socioeconomic outcomes.