High rates of opioid-related deaths across Canada have been a significant and longstanding national public health issue. In 2019, there were almost 4,000 opioid-related deaths across the country, of which over 94% were accidental. The COVID-19 pandemic emerged in the midst of this ongoing epidemic of opioid-related deaths, and resulted in the declaration of a state of emergency in Ontario on March 17, 2020.3 Given the rapidly changing nature of the pandemic and the continued rise in opioid-related deaths, a comprehensive understanding of the circumstances surrounding these deaths is needed to inform multifaceted public health interventions and policies that support people who use drugs to help prevent opioid-related mortality and reduce morbidity. This report updates the data provided in the preliminary report to include patterns up to the end of December 2020.