COVID‐19 temporarily severed the production and the supply chains for fentanyl, a synthetic narcotic responsible for over 30,000 deaths in the United States in 2018. Much fentanyl was produced in Wuhan, China, the source of the epidemic. Fentanyl was previously sold directly to American consumers through online websites and was also supplied by Mexican drug traffickers, who produced the drug from precursor chemicals purchased from China. With the advent of the pandemic, websites from Wuhan‐based sellers reported that the drugs were not being produced or shipped. Moreover, Mexican drug traffickers were deprived of the precursor chemicals to produce this highly potent opioid. Despite the reduced entry of illicit fentanyl to the United States, enough was stockpiled by drug traffickers perpetuating a very serious problem of illegal fentanyl abuse. Deaths have increased since the start of the COVID epidemic, as the problems of drug abuse have not stopped and access to treatment and medical services are diminished. Moreover, isolation and lack of social support compound the problem. The initial data on increased deaths from illegal fentanyl consumption are consistent with the overall picture of the impact of the COVID epidemic. Those who are most vulnerable are suffering disproportionately from the drug trade.