Indigenous people who use drugs in BC are facing two public health emergencies: COVID-19 and the ongoing overdose crisis. One likely creates additional risk for the other. On one hand, COVID-19 and its response may affect access to clean smoking/injection equipment, safe supply of illicit drugs, income, and health and social services. Pandemic fears and restrictions may also impact mental wellbeing. On the other hand, substance use may increase COVID-19 risk through sharing smoking/injection equipment; barriers to physical distancing; and housing instability. Our study assesses impact of COVID-19 and the pandemic response, as well as its domino effects, among Indigenous people who use drugs. The study will inform a culturally-safe, trauma informed response for this population.