The opioid overdose death rate in New York State has grown exponentially over the past decade. Between 2010 and 2015, the age-adjusted rate of all overdose death per 100,000 residents doubled in size, from 5.4% to 10.8%. Correspondingly, the heroin overdose death rate increased five-fold between 2010 and 2015, from 1.0% to 5.4%. Accidental drug overdose is currently the leading cause of injury-related death for people between the ages of 35-54, and the second leading cause of injury-related death for people ages 18-34. The sharp upswing in overdose-related mortalities has created myriad issues for healthcare professionals, who have had to respond to this crisis in a short span of time. While agencies, lawmakers, families, and communities throughout New York State contend with this public health crisis, professionals in the behavioral health field have encountered another growing issue: how do we respond to the emotional and psychological toll of this unprecedented death rate? How do we care for our patients during such a difficult time, many of whom have experienced the overdose death of a friend or peer? What are the best ways to support both staff and clients? While grief and loss have always been an aspect of therapeutic work, the opioid epidemic, and its attendant overdose rate, has created new dimensions and considerations for the staff members witnessing and responding to its effects.