Key findings:

• There was a substantial decrease in the availability and capacity of substance use treatment and harm reduction services in the early phase of the pandemic (March–June) due to closures and restrictions on the number of clients allowed at clinics and inpatient facilities.

• This decrease, along with other factors, led to many clients returning to or engaging in higherrisk substance use, and growing wait times for services.

• Access to substance use treatment services and supports has not returned to pre-pandemic levels.

• Delivery of care for substance use treatment shifted rapidly to virtual platforms, which had some positive impact on treatment access.

• Availability of virtual care is not equitably distributed, and it cannot completely replace the need for in-person treatment options.