With this project entitle, "Expanding access to culturally responsive medication assisted treatment (MAT) through urban tribal partnership", we will reduce the disparities among Minnesota Native Americans (NAs) struggling with Opioid Use Disorder (OUD) by increasing access to culturally responsive MAT services. NAs in MN have the highest rate of death due to drug poisoning (compared to Whites). Red Lake Nation and Native American Community Clinic's (NACC) MAT program, Wiidookodaadiwin (We Help Each Other), established in 2016, prescribes FDA-approved oral Suboxone (Buprenorphine/Naloxone combination) for the treatment of OUD among NAs in Minneapolis, MN. After receiving the Substance Abuse Mental Health Service Administration (SAMHSA) MAT Prescription Drug an Opioid Addiction (MAT-PDOA) in 2018 the MAT program expanded to include a dosing program with an Elder in Residence to provide holistic care and traditional healing services, and also recovery support services, behavioral health therapies, and community health education. The program has had great success. Between intake and the 6-month follow-up the Government Performance and Results Act (GPRA) survey data showed that MAT clients experienced a decrease in drug use (64% to 52%), increase in drug abstinence (33% to 48%), increase in housing stability (29% to 35%), decrease in emergency room visits (15% to 0%), decreased trouble in understanding, concentration or remembering (65% to 31%), and more frequently reported their quality life as "good" (40% to 55%). Likewise, there was an increase in the clients reporting that they were "completely" had enough energy for everyday life and were "satisfied" with their overall health, their ability to perform everyday tasks, and with themselves. At the same time, clients experienced a negative trend in unemployment and financial distress, depression and anxiety, social isolation and child protection involvement; which require further evaluation. There is more work to be done; our objective includes: 1) increase in the number of NAs receiving MAT; 2) decrease illicit opioid drug use and prescription opioid misuse at six-moth follow-up; 3) improve outcomes for employment, financial distress, housing stability, depression and anxiety, social connectiveness and child protection involvement; and 4) enhance cultural adaptations, based on promising practice, to meet the unique needs of NA families and draw on their strengths. Key activities include but are not limited to: Outreach, telehealth, increased collaboration with external stakeholders, and document and share culturally responsive promising practices. Based on the last three years of this work, and upcoming plans for expansion we estimate serving 40 individuals in year one, 50 in year two, 60 in year three and four, and 70 in year five; for a total of 280 unique individuals.