The Texas Targeted Opioid Response (TTOR) addresses the opioid crisis and rising trend in harmful stimulant use by reducing both unmet treatment need and overdose death. This is accomplished through the provision of prevention strategies that address overdose and harmful opioid and stimulant use, medication assisted treatment, medication assisted recovery support, and integrated prevention, treatment, and recovery projects. Five groups in Texas have been identified at highest risk for opioid use disorder, harmful stimulant use, and their consequences: 1) people living in major metropolitan areas, 2) pregnant and postpartum women, 3) justice-involved individuals, 4) people with a history of prescription opioid misuse, polysubstance use, or at risk of developing opioid use disorder, and 5) tribal communities. TTOR aims to continue its investments in prevention, treatment, and recovery services. These include a public education campaign promoting healthy behaviors and educating about the harms of opioid misuse, a statewide overdose prevention education and naloxone distribution program, maintained capacity expansion for opioid treatment services (both in clinic and office-based settings), treatment for comorbid conditions such as HIV and viral hepatitis, and a project to increase recovery support services that boosts peer support, housing, and re-entry recovery capital. Finally, TTOR will ensure continuity of care through integrated in-patient hospital settings, pre-arrest diversion, and community access programs that blend prevention, treatment, and recovery services that reduce barriers to access. Through partnerships with community agencies and governmental entities, such as public universities and city and county governments, TTOR will serve approximately 2,576,729 persons each year and 5,158,550 during the project period of September 1, 2020 through August 31, 2022.