The rate of drug overdose deaths has increased substantially in the United States in the past two decades. However, limited research has examined how the criminal justice system is responding to this growing epidemic. Using data on criminal sentences in federal district courts, the current study assesses the relationship between drug overdose death rates and criminal sentences in the United States. Results from multilevel regression models demonstrate that sentences for federal drug offenders were shorter in areas that experienced higher overdose rates and increased growth in overdose rates over time. Findings also demonstrated substantial heterogeneity by drug type, such that substances most closely associated with the overdose crisis (i.e., pharmaceutical opioids and methamphetamines) were sentenced less harshly in areas with higher drug overdose rates. Analyses assessing the change in overdose rates over time, demonstrated that several substances (crack-cocaine, heroin, marijuana, and methamphetamine) were sentenced more harshly in areas with greater growth in the overdose rate, whereas cocaine and pharmaceutical opioids were not impacted by changes in drug overdose rate. These findings are interpreted through the lens of theoretical perspectives and contemporary research pertaining to ways levels of crime and social problems influence punishment decisions.