Three Rivers Community Opioid Intervention Pilot Project (Three Rivers) - Native Directions, Inc., dba as Three Rivers Indian Lodge is requesting support for the Three Rivers Community Opioid Intervention Pilot Project (Three Rivers) San Joaquin County, California is home to many American Indians; however, little is known about the American Indian/Alaska Native (AIAN) in San Joaquin County. Researchers comparing AIAN living in urban areas with the general urban population identified disparities in socioeconomic, maternal and child health, and mortality indicators. AIAN are about twice as likely as the general population to be poor, unemployed, and not college educated. Similar differences were observed in births among mothers who received late/no prenatal care or consumed alcohol and in mortality attributed to sudden infant death syndrome, chronic liver disease, and alcohol consumption. In 2017, there were 57 opioid-related deaths, the highest among all surrounding counties. Three Rivers is located in Manteca, San Joaquin County, California and serves a county-wide American Indian/Alaska Native (AIAN) population of 38,533 AIAN residents. It was founded in 1972 by a small group of Native men seeking a place to gain a sober way of living. The Lodge moved from Stockton in 1974 to its present location in Manteca, California, between the three rivers flowing through the Central Valley--the Stanislaus, San Joaquin and Mokelumne rivers. For over 45 years, Three Rivers Indian Lodge has provided alcohol and substance abuse treatment services through spiritual/cultural practices such as sweat lodge ceremonies, drumming, beading, and talking circles, coupled with residential treatment based upon the 12-Step, White Bison, and Red Road Recovery models to treat thousands of Native men seeking recovery from addiction. In 2018, Three Rivers served 41 residential clients. Of these, 39 were being treated for alcohol addiction, and of these, 36 were dually diagnosed for drug addiction, including 17 with OUD. Over the course of its history, Three Rivers has successfully graduated approximately 3,800 out of 4,100 clients! Three Rivers is one of two substance abuse treatment facilities in California and works to fill gaps in access and care though direct services and through partnerships with other AIAN and social support organizations. Agency staffs have the expertise and experience to build capacity among Native and non-Native treatment providers and awareness within the AIAN community to address opioid use disorder. Three Rivers has a plan to help the AIAN community in San Joaquin County by increasing knowledge and awareness of, and access to medically-assisted treatment (MAT), increasing screening for alcohol and drug use, increasing referrals to needed services, and improving access to culturally competent providers. The overarching goal of Three Rivers Community Opioid Intervention Pilot Project is to increase knowledge of, and access to, medically assisted treatment (MAT) within the American Indian/Alaska Native community in San Joaquin County, California. This will be accomplished through three objectives and related activities. Objective 1. Increase AIAN community awareness and education about culturally-appropriate and family-centered opioid prevention by 25% by program end. Objective 2. Expand access to culturally attuned MAT services by 10% by program end. Objective 3. Build a support system for referrals to strengthen Native families by implementing culturally-appropriate approaches by program end.