As drug overdoses continue to rise, public health scholars have called for more research to understand opioid and other substance misuse and offer treatment and intervention recommendations, particularly for persons with criminal justice system involvement. This study linked fatal opioid-related overdose data with criminal history data to inform responses to unintentional fatal drug overdoses and identify where and when connections between health and justice systems may be most beneficial. Findings revealed that overdose decedents often had multiple risk factors and repeated interactions with the criminal justice system. Substance use disorder and mental health treatment, as well as harm reduction strategies, should be offered at each step in the criminal justice system to decrease risk for fatal overdose, particularly for those after released from incarceration.