The Mississippi Band of Choctaw Indians (MBCI) Tribal Opioid Response Project is designed to address the opioid crisis by providing a continuum of culturally appropriate evidence-based prevention, medication-assisted treatment, and coordinated recovery support services for tribal members diagnosed with opioid use disorder (OUD). To achieve the development of comprehensive OUD services the following framework will be utilized: (1) Increase workforce capacity to prevent and treat opioid misuse; (2) Develop effective prevention strategies which include but are not limited to: elder education, outreach and engagement of youth, strategic messaging, and community prevention activities; (3) Increase dissemination and utilization of naloxone;(4) Implement and expand access to MAT using FDA approved medications for the treatment of OUD; (5) Utilize an ongoing Continuous Quality Improvement (CQI) framework to assess the implementation and impact of the grant. The proposed work includes; expanding proven and effective strategies for the prevention of opioid misuse through a tribal wide employee education campaign; creating an Overdose Education and Naloxone Distribution Program to provide tribal-wide training around OUD and overdose prevention to law enforcement, fire fighter, and security personnel located in public and school settings; and expanding peer support services to ensure the likelihood of recovery success. A comprehensive performance assessment process will support ongoing evaluation of progress against proposed goals, objectives, and activities and guide continuous quality improvement efforts to make streamlined data-driven decision throughout the project. The MBCI is a federally recognized tribe with over 11,000 members and 88% of members reside on or near the Choctaw Indian Reservation located in rural, east central Mississippi. The Choctaw Behavioral Health Program had 32,487 patient contacts related to mental, emotional, and substance abuse-related issues in 2017. MBCI operates its Behavioral Health Program within the continuum of health care services at Choctaw Health Center and provide culturally sensitive treatment services to patients with mental health-related issues. The project anticipates serving 80unduplicated individuals with a total project reach of 5,500 patient contacts for OUD over the two-year project. In addition to the traditional outpatient treatment services, intensive outpatient programs, prevention groups, recovery maintenance groups, self-help groups, psychiatric services, and process addiction services, MBCI plans on expanding and improving OUD services with those involved within the criminal justice system to promote alternatives to incarceration and seamless transition back into their communities.