In 2019, there were there were 24,166 overdose ambulance calls (~66/day) in BC, and in the Vancouver Coastal Health Region 39% of all ambulance calls were for an overdose. In 2020, 1,767 British Columbians died of an illicit drug overdose (~5/day) vs. approx. 957 from COVID-19 (~3/day). Harm reduction has certainly helped but is clearly not enough to keep things from getting worse. Stopping the overdose crisis will require improving our understanding of substance use disorders and risk factors for overdose that can be used to develop effective preventative measures. In collaboration with Dr. Amanda Slaunwhite at the BC Centre for Disease Control, we are investigating the socioeconomic, demographic, and health determinants of overdose using data on a total of 987,406 individuals from the BC Provincial Overdose Cohort and a 20% sample from the general BC population. In this talk, I will share some preliminary results from an overdose prediction model capable of predicting 80% of overdose cases per year and which identifies vulnerable segments of the BC population for whom additional interventions and supports may have the most impact.