The pandemic has increased risk factors for the development of substance abuse disorders and overdoses, such as isolation and economic distress. High COVID-19 related worry has been shown as a predictor of beginning substance use during the pandemic , and increasing numbers of overdoses have been reported nationwide . An increase in the amount of emergency responses necessary for opioid overdoses has occurred in some locations . Locally, there were 36 fatal overdoses during the study period in the towns/cities served by the East Shore Water Pollution Abatement Facility in New Haven (New Haven, East Haven, Woodbridge, and Hamden) . Thirty-two of these overdoses involved opioids, including 28 where fentanyl was detected. Cocaine was involved in 17 of the overdose deaths. Most cases included multiple drugs . Additionally, the COVID-19 pandemic has caused many changes in treatments for both pain and substance abuse disorders, which usually depend heavily on in-person interactions and carefully controlled access to medications. New systems for opioid distribution and telemedicine appointments have been developed but there is continued concern over their effectiveness .