Opioid use and misuse are on the rise in the Yukon Kuskokwim (Y-K) Delta of southwest Alaska. The popularity of opioids is on the rise due to its low cost of production, ease of transportation and affordability for the user. The Yukon Kuskokwim Health Corporation’s (YKHC) Tribal Opioid Response Grant (TOG) Program provides residential and outpatient opioid treatment, and community outreach and education to our many tribal communities. The Y-K Delta region in southwest Alaska is home to 58 Federally recognized tribal communities, more than 10% of the 566 Federally recognized tribes in the United States. Our region is in a very rural setting where no road system exists, and air travel is the standard method of transportation. The population of 27,000 residents is scattered over 75,000 square miles, an area larger than the state of Washington state. YKHC, a consortium of tribes, is the sole direct service provider for the communities in the Y-K Delta region, which is one of the economically poorest regions in the state. YKHC is a member of the Alaska Tribal Health Compact, which is made up of the 12 region tribal health organizations that serve the state of Alaska. The communities of the Y-K Delta were once health and self-sufficient, free from alcohol, drugs and diabetes, but today they suffer a highly disproportionate rate of substance abuse, suicide and depression, domestic violence, STDs, and poverty. Our history of oppression, colonization, epidemics and boarding schools devastated our villages, and resulted in severe social issues that are destroying our people. Now it is the Opioid epidemic that threatens our people, our families and our children. The YKHC TOG Program will 1) enhance the current Opioid Treatment Program to serve up to 40 clients per year, 2) expand existing treatment services available to the patient, and 3) increase our community outreach and education program that travels out to the villages to teach young people and adults about the dangers and realities of opioid abuse, and also get to know and build a network of community-based providers and advocates who can refer clients in for treatment. The clients we serve can be broken down into two categories: Inpatient Opioid Treatment and Community Outreach and Education. During year 1 of the grant we will serve 35 inpatient opioid treatment clients, and 175 participants in the Opioid Outreach and Education activities. In year 2 we will increase to 40 inpatient treatment clients, and Outreach and Education will increase to 200.