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01, 95% Confidence Interval [CI] 1.29-3.15), at least weekly injection drug use (AOR=1.94, 95% CI 1.40-2.71), at least weekly crack use (AOR=1.61, 95%CI 1.10-2.36), and at least weekly crystal methamphetamine use (AOR=1.46, 95%CI 1.03-2.08). Over a third of PWUD perceived that the quality of drugs declined during the COVID-19 pandemic and these individuals were significantly more likely to report experiencing a recent non-fatal overdose, engaging in frequent injection drug and stimulant use. Study findings indicate the need for interven

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