The COVID pandemic significantly worsened the impact of Canada’s opioid crisis. Toxic drugs became more dangerous as they were more likely to be laced with synthetic opioids like fentanyl. Stay-at-home measures reduced access to supports, supervised injection sites, and social services. And increased isolation, anxiety, and stress contributed to increased use of opioids. Psychological approaches such as cognitive behavioural therapy, contingency management, and behavioural interventions are effective at treating Opioid Use Disorder, and are almost always combined with medications, like methadone.