The following report describes findings from a Public Health Ontario funded Locally Driven Collaborative Project that described regional changes to harm reduction service delivery and opioid-related morbidity and mortality in Ontario over the course of the COVID-19 pandemic. Virtual snapshots displaying trends over time were developed by the project team to describe changes that have occurred within each of the 34 health unit regions in the province over the last several years, and includes comparisons to Ontario-level data. These snapshots were created for use by public health units, organizations specializing in harm reduction, and other interested individuals, organizations and networks to enhance situational awareness and support program planning and advocacy efforts to address the opioid toxicity crisis.