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Methods| The Columbia University Medical Center institutional review board waived study review and also waived the need for patient informed consent because this research did not involve human subjects research. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. For this crosssectional study, all fatal drug overdose records from the Cook County, Illinois, medical examiner were obtained for the period August 1, 2014, through December 31, 2018. The records included full toxicology reports; Global Positioning System (GPS) coordinates for overdose location; zip codes of home residence; and age, sex, and race/ethnicity (eMethods in the Supplement). Public transit data included Chicago Transit