evidence: The findings in this report are subject to at least five limitations. First, jurisdictions included in nonfatal and fatal overdose analyses are not nationally representative and differ from each other, limiting the extent to which trends can be compared. Second, full toxicology results for nonfatal overdoses were not available, and opioid and benzodiazepine involvement in nonfatal overdoses is likely underestimated because comprehensive toxicology testing of persons treated for overdoses varies within and across EDs, and hospital discharge codes with drug specific information might be unavailable (8). Third, despite only including consistently reporting facilities, ED visits decreased sharply after implementation of COVID-19 mitigation measures in March 2020, which might inflate rate increases (9). Fourth, four states (Illinois, Missouri, Pennsylvania, and Wisconsin) reported overdose deaths from varying subsets of counties. Results were similar with and without these states. Finally, postmortem toxicology testing and drug involvement determination vary over time and across states, potentially affecting detection of specific drugs involved in deaths.