The Ho-Chunk Nation Health Department will increase identification and MAT treatment of individuals with opioid use disorders (OUD) and referrals to appropriate treatment utilizing the SAMSHA Screening, Brief Intervention, and Referral to Treatment (SBIRT) model. We will embed Behavioral Health Care Managers at the medical clinic nurses stations who will conduct a PHQ-9 and DAST-10 screening, perform brief intervention, and refer patients to Behavioral Health Services in order to increase referrals to Behavioral Health by 50%. We have identified a goal of assisting 100 individuals who present opioid use disorder diagnosed in medical clinic engaging in Medically Assisted Treatment Vivitrol Program. By enrolling in the Vivitrol Program we anticipate a decrease in illicit opioid drug use and prescription opioid misuse at six-month follow-up. Through consistent use of the Vivitrol Program and Behavioral Health within 2 years we will achieve 80% opioid dependence abstinence evidenced by urine drug screen results resulting negative for opioids, buprenorphine, and methadone at six-month follow-up after initiating MAT. Along with decreased use, over-dose deaths in the Ho-Chunk Nation communities will be decreased through training HCN community members and HCN gaming facility security/EMT employees and dispensing of naloxone (Narcan®) during trainings and from HCN pharmacies using the Pharmacist Prescribed Naloxone Standing Order. Pharmacy Division staff will conducte at least 1 naloxone training at every HCN gaming facility and 2 naloxone training in every HCN community defined by the Contract Health Service Delivery Area (CHSDA). We will measure the decreased opioid overdose deaths by data collection from HCN police reports, local emergency room reports, pharmacy naloxone refill reports, and community reports.