Rural Communities Opioid Response Program-Impact - WestCare Kentucky and the Appalachian Recovery Care Network will provide services in the rural target service area of Pike and Letcher Counties. All of Pike and Letcher counties are HRSA-designated rural areas. This area is located in eastern Kentucky in rural Appalachia. The population to be served includes: 1) individuals who are at risk for, have been diagnosed with, and/or are in treatment and/or recovery for opioid use disorder (OUD); 2) their families and/or caregivers; and 3) other community members who reside in the rural area. The data focus area will be justice-involved adults. The goals of the project are to 1) establish and coordinate comprehensive substance use disorder (SUD) treatment with a focus on opioid use disorder (OUD) and recovery services, residential and outpatient treatment and counseling, wraparound support services, and peer support; 2) to develop a responsive and qualified workforce in rural Appalachia in Eastern Tennessee including peer support specialists and clinical professionals offering diverse services; 3) to establish and enhance coordination of supportive social services and wraparound care to ensure rural adults impacted by SUD/OUD have sustained, long-term recovery through the work of the Appalachian Recovery Care Network with representatives from local, diverse service sectors, and 4) to develop innovative, multi-sectoral approaches to funding sustainability, community support and the continuation of RCORP Impact Services beyond the initial 4-year project period. The Appalachian Recovery Care Network comprises four community organizations that collaborate and coordinate services. The Network includes behavioral health, substance use treatment, Medication Assisted Treatment (MAT), primary healthcare, recovery services, transitional housing, harm reduction, prevention, and education to provide whole-person, trauma-informed, evidence-based services to address the high rates of opioid and substance use overdoses, deaths, and misuse in rural eastern Kentucky. This project will expand and enhance existing services that contribute to a comprehensive system of care. Services include outpatient SUD/OUD treatment; telehealth services; primary health care; psychiatric/psychological care; outreach; screening; case management and assessment; counseling; co-occurring disorder treatment and mental health care; mobile unit services to bring services directly to people; SUD/OUD prevention and education, life skills and support services, Peer Support services, recovery support; addiction support groups, vocational and education services along with evaluation and performance improvement services. Kentucky has one of the highest opioid overdose mortality rates in the United States. The mountainous terrain, narrow valleys, and river flooding have led to geographic isolation that hinders transportation and development, resulting in difficulty in achieving economic development, health, and educational goals. After decades of dependence on a coal economy, these counties are experiencing outmigration as many people leave the area searching for self-sustaining employment opportunities. The area is a significant center of illegal drug prosecution, manufacturing, importation, or distribution; State, local, and tribal law enforcement agencies have committed resources to respond to the drug trafficking problem in the area, thereby indicating a determination to respond aggressively to the problem; Drug-related activities in the area are having a significant harmful impact in the area and reflects the day to day drug-related activities the target population must endure.