The opioid epidemic in the United States is a public health crisis, which has claimed more than 450,000 lives since its inception in 1999. In Virginia, the death rate from any opioid  increased yearly from 9.6 deaths per 100,000 residents in 2015 to 14.1 deaths per 100,000 residents in 2017. According to the Centers for Disease Control and Prevention (CDC), one in four patients who are prescribed opioid drugs for long-term therapy in primary care settings will struggle with opioid addiction. The COVID-19 pandemic has both exacerbated pre-existing barriers and created more barriers for these patients. The objective of this study was to describe changes in emergency department (ED) visits related to opioid overdoses on a population level in Virginia from 2019 to 2020, immediately before and during the COVID-19 pandemic, and to identify county-level factors associated with increases in these visits. Data was gather from the Virginia Department of Health and the US Census Bureau and analyzed via logistic regression. The results from this study found that there appears to be a decrease in units of rurality related to a percentage likelihood increase in ED visits related to opioid overdoses during the COVID-19 pandemic. This study also found that counties which experienced an increase in ED visits related to opioid overdoses correlate with being more urban and having a higher percent of white-identifying residents. These results point to the need for research on how policy changes during emergencies can affect the mental health and wellbeing of constituents.