Friedman J, Mann NC, Hansen H, et al. - In this cohort study of 83.7 million EMS patient encounters, racial/ethnic, social, and geographic trends in emergency medical services (EMS)-observed overdose-associated cardiac arrests during the COVID-19 pandemic through December 2020 are determined. In addition, their concordance with CDC-reported provisional total overdose mortality through May 2020 was examined. Analysis revealed about a 40% rise in overdose-associated cardiac arrests, nationally, in 2020, with the largest increases among racial/ethnic minorities, in areas of socioeconomic disadvantage, and in Western states. This underscores the necessity for investments in overdose prevention as an essential element of the COVID-19 response and post pandemic recovery, especially for communities with greater vulnerability. Overall there was high concordance with provisional total overdose death figures through July 2020.