The Louisiana State Opioid Response (LaSOR) Project 2.0 will enhance existing statewide prevention, intervention, treatment, and recovery support services statewide for individuals with or at risk for opioid use disorder (OUD) or stimulant use/misuse (SUM).The priority populations to be served by this grant are: (1) the under- and uninsured, (2) the criminal justice population, (3) tribes, (4) pregnant women or women with infants experiencing neonatal opioid withdrawal symptoms, (5) people who inject drugs, (5) colleges and universities, and (6) school age children (for prevention). The goals of LaSOR 2.0 include: 1) Identify and address needs of state and federally-recognized tribes; 2) Decrease opioid and stimulant overdose death rates by increasing access to treatment services for the under- and uninsured with OUD or SUM; 3) Increase access to community recovery support services for patients with OUD or SUM; 4) Increase prevention, intervention, and education activities for opioid and stimulant use, misuse, and abuse; 5) Provide treatment transition and referral for patients reentering communities from criminal justice settings; and 6) Increase access to harm reduction strategies and linkage to HIV and viral hepatitis testing for priority populations. LaSOR 2.0 will provide a variety of services for 3,095 unduplicated individuals (1,355 in year one and 1,740 in year two). LaSOR 2.0 will expand and enhance the existing hub and spoke model, with Opioid Treatment Programs (OTPs) serving as hubs and Office Based Opioid Treatment (OBOT) providers serving as spokes. OBOT providers will receive support from Spoke Care Teams, education and consultation from Tulane University through academic detailing and Project ECHO, and psychiatric consults from Louisiana State University Health Sciences Center. In addition, the Mother-Baby Substance Exposure Initiative (MBSEI) will provide five birthing facilities with a patient navigator to connect identified women with treatment, resources, and providing social support as needed. Prevention and intervention strategies include education through the Prescription Drug Abuse Prevention Module of Life Skills Training, the Opioid Module of Project Alert and Generation Rx; safe storage and proper disposal of prescription medications; distribution of Narcan Kits to institutions of higher education, first responders, jails, and federally qualified health centers; faith based community partnerships; and a media campaign. OBH will host webinars and on-site trainings for healthcare professionals on opioid use, stimulant use and non-drug alternatives to pain management. In addition, peer trainings and webinars for institutions of higher education will be held. In addition, OUD in college students will be addressed through collegiate recovery programs and an evidence based substance use screening and assessment tool for university health centers. Community recovery support strategies include expansion of Oxford Houses statewide; Crisis Outreach Mobile Teams that will provide outreach services and mobile peer recovery services; placement of Peer Recovery Support Specialists in hospital emergency departments; and grief groups for families and loved ones who experienced a loss due to an opioid overdose. A pre-release opioid treatment program will be expanded in correction facilities to address OUD and SUM in the criminal justice population. In addition, Health Coordinators will be provided to Syringe Service Programs to expand harm reduction strategies and linkages to Hepatitis C and HIV testing. Finally, the needs of state and federally-recognized tribes will be identified through a thorough needs assessment and addressed through strategy implementation. This list of coordinated prevention, intervention, treatment, and recovery support services will increase Louisiana's capacity to address issues of opioid use across our state.