We determined if the Rhode Island Real-time Outbreak and Disease Surveillance (RODS) system identified an increase in emergency department (ED) overdose visits during a known cluster of illicit-drug overdose deaths in RI and characterized ED overdose visits. When stratified by ED there was a significant increase in overdose chief complaints from one ED during March - May 2013 compared to the previous year. This coincides with the cluster of drug overdose deaths in March 2013. Despite most chief complaints for overdose not specifying cause, syndromic surveillance systems provide an existing platform that could be used to better assess ED overdose visits.