Introduction: Opioid overdose occurs when a person takes opioid or opioid in combination with other drugs, in quantities that body cannot handle. Overdose is one of the commonest causes of death among opioid users. With the rising number of drug users in our state, incidences of drug overdose is bound to increase. Objectives: 1. To find out the number and profile of overdose cases presenting to different Health Care institutions under this study.2.To find out the knowledge and practices of Health Care Providers on overdose management. Methodology: The present study is a cross sectional study conducted in selected districts of Meghalaya for a period of one year. A total of 20 centres were taken up for data collection. Doctors, nurses and para medical staff were the study respondent. Pre-designed questionnaire was used for data collection. Results: From the 20 centers, a total number of 114 respondents were enrolled for questionnaire section. Regarding the knowledge on overdose 101 (88.59%) could properly define the meaning of overdose. Only 41(36%) of the respondent had treated overdose cases. Only 66 (58%) respondents were aware about the correct dosage of naloxone Regarding the drug used to revive an overdose case most of the respondents 61 (53%) replied that they would use Naloxone. However Only 21 (18%) of respondents had undergone any training on overdose management. There are about 80 reported cases of overdose with the mean age of 28 years. Out of the 80 overdose cases 17 (21%) cases were fatal. Only 25 (31%) overdose cases were reported to the police.