This article reviews the burden of accidental poisonings from opioid overdoses in the United States, describes several current federal- and state-level prevention strategies, and illustrates several approaches taken to prevent deaths from opioid overdoses and reduce emergency department visits for chronic pain. One approach, Project Lazarus in North Carolina, is a community-based, secondary prevention program that trains medical care providers to coprescribe naloxone with opioids and provide education to patients who are at risk of opioid overdoses and to their families and peers.