Heroin, prescription pain relievers, and synthetic opioids such as fentanyl have contributed to a national epidemic which poses special challenges for the justice system. Drug courts continue to play an irreplaceable role in the response to this epidemic, but they are not enough. New evidence-based justice system approaches are needed to prevent overdose deaths, including medication-assisted treatment and wraparound supports. This document provides a snapshot of some of the strategies being used by courts and practitioners around the country to prevent overdose deaths and save lives.