During the COVID-19 outbreak, there was a surge in overdose-related deaths with the CDC estimating a 38.4% increase in opioid-related deaths and a 26.5% increase in cocaine-related deaths during June 2019-May 2020, when compared to the 12 months prior1. With subsequent surveillance data confirming this trend, it is evident that COVID-19 had a unique impact on people who use drugs (PWUD). However, the psychosocial, socioeconomic, and biopolitical effects of the pandemic on PWUD are poorly understood. The COVID-19 pandemic resulted in disruptions to illicit drug supplies in Canada, leading to increased use of contaminated and variably potent substances2. With social distancing guidelines in place, syringe service programs were deemed non-essential in many areas, effectively cutting off the supply of safe injection materials while contaminated drugs circulated. Given this background, it is necessary to better understand the ways COVID-19 has impacted the health and behaviors of PWUD. By engaging directly with PWUD in Sacramento County, this mixed-methods project aims to go to the source and address this important gap in knowledge.