Death from opiate overdose is a cause of mortality both in the United States and internationally. All drug users are at risk for overdose. However, those recently released from institutional settings, particularly prison, have greater mortality rates than their peers. The results of this study highlight the significant risk of overdose among long-term drug users being released from prison. The majority of subjects had both witnessed and experienced an overdose. Among those with a recent personal history, nearly two-thirds of incidents had occurred within 1 month of release from an institutional setting. Only approximately half of respondents reported calling 911 in the event of an overdose, with fear of police involvement and a belief that they could handle the situation themselves among the most common reasons for not calling. Given the success of peer-administered Naloxone, the incorporation of overdose prevention education and the distribution of Naloxone during the discharge planning process would be a feasible intervention to significantly reduce mortality rates among opiate users. Release from detox centers, methadone maintenance programs, and hospitals would be other critical moments to implement Naloxone distribution. Data were collected from 137 long-term opiate users involved in the criminal justice system who were administered a 73-question survey concerning their drug use and overdose history. Tables and references