<p>People who use opioids (PWUO) have asserted police opioid seizures increase risk of overdose in their proximate aftermath. Ecological studies and causal models exhibit a positive association between police opioid seizures and overdose risk. To further characterize this relationship, this qualitative study explores how police officers who conduct drug enforcement understand the relationship between their opioid seizures and overdose risk. Semi-structured interviews were conducted with officers from the Providence, Rhode Island (USA) Police Department (<i>n</i> = 26) who patrolled areas with highly concentrated public substance use, or who conducted narcotics investigations. Interviews explored beliefs about the effects of police opioid seizures on overdose risk, reasons why seizures may modify this risk, and the motivations for narcotics enforcement. In contrast to patrol officers, narcotics investigators and patrol supervisors with narcotics investigation experience expressed four themes: (1) police opioid seizures increase subsequent overdose risk; (2) the reasons why closely track accounts put forth by researchers, and PWUO who experience this risk firsthand; (3) this risk was one of many faced by PWUO, and (4) police narcotics work should weigh it against the perceived need to address the effects of the illicit narcotics trade on a community. This consensus across diverse study populations, supported by ecological research and causal models, suggests the overdose risks generated by police opioid enforcement should be taken seriously in formulating drug policy.</p>