Part of the problem is the reporting guidelines

If COVID-19 is a cause, it goes in section 1, and other contributing issues go in section 2. Covid only needs to be a cause, not the cause.

So if this individual OD’d, and also had Covid symptoms (or positive test), that would be reported as Covid in section 1 on the death certificate.

Link: https://www.cdc.gov/nchs/covid19/coding-and-reporting.htm