Ann & Robert H. Lurie Children’s Hospital of Chicago’s Potocsnak Family Division of Adolescent & Young Adult Medicine (LCH) seeks a three-year grant of $375,000/year for Reaching Every Adolescent in Chicago through Harm reduction (REACH), a trauma-informed, evidence-based outreach intervention that delivers harm reduction education and supplies, SUD/COD screenings, and referrals to treatment and recovery supports to Chicagoans ages 16–25 in community settings. While all Chicago youth ages 16–25 will be eligible, REACH focuses on low-income, Black, Indigenous, and People of Color (BIPOC), and/or sexual minority (LGBTQ+) populations in under-resourced community areas experiencing a high prevalence of substance use/misuse disorders, mental health disorders, and trauma. REACH leverages LCH’s Mobile Health Unit (MHU) to reduce barriers specific to youth engagement (e.g., lack of familiarity with available behavioral health resources, lack of knowledge around accessing SUD/COD diagnosis and treatment, and/or lack of transportation to clinic locations). In partnership with four community-based providers of youth services—Lawrence Hall (South Side), Youth Outreach Services (South and/or West sides), Ignite (South Side), and Phalanx Family Services (Far South Side)—LCH will deploy the MHU to partner agency sites to engage youth populations already accessing other services via these providers. Throughout the project, REACH staff will use Motivational Interviewing, Contingency Management, and Text-Messaging Interventions to encourage uptake of REACH services and adoption of healthier behaviors. Goals/Objectives: 1) Decrease incidence of opioid-related overdoses and fatalities among Chicagoans ages 16–25 by distributing opioid harm-reduction supplies to youth and providing related overdose prevention education to youth and youth-service providers. Objective 1a: REACH will provide Overdose and Disease Prevention Kits (including Narcan [naloxone] and fentanyl test strips) and related training to at least 45 unduplicated youth in Year 1 (Y1) and at least 60 unduplicated youth annually in Year 2 (Y2) and Year 3 (Y3), serving at least 165 unduplicated youth in Y1–Y3. Objective 1b: REACH will train staff at partner agencies to identify opioid substances, recognize an opioid overdose, and administer Narcan. LCH will train a minimum 30 unduplicated provider staff in Y1 and a minimum 10 unduplicated provider staff annually in Y2 and Y3, training at least 50 unduplicated provider staff in Y1–Y3. 2) Increase local capacity to identify Chicagoans ages 16–25 in need of SUD and/or COD treatment and recovery supports. REACH will offer SUD, COD, and recovery support screenings to participating youth. Objective 2a) REACH will provide screenings for SUD, COD, and recovery supports to at least 19 participating youth in Y1 and at least 25 participating youth annually in Y2 and Y3, screening a minimum 69 participants in Y1–Y3. Objective 2b) By the conclusion of Y3, 62 REACH youth (90%) will screen positive for SUD/COD and needed recovery supports.3) Strengthen access to SUD/COD treatment and recovery supports for Chicagoans ages 16–25. LCH will refer REACH youth screening positive for SUD/COD to applicable clinical services at LCH or another preferred provider, as well as to any needed recovery supports (e.g. transportation assistance, housing services) to promote engagement/retention in care. Objective 3a: LCH will refer at least 17 REACH youth to treatment and recovery supports in Y1 and at least 22 REACH youth annually in Y2 and Y3, referring a minimum 61 participating youth to individualized clinical care and wraparound supports in Y1–Y3. Approximately 50% of youth screening positive will initiate treatment/recovery supports. Objective 3b: Nine (9) participating youth in Y1, and 10 participating youth annually in Y2 and Y3, will initiate care, for a total 29 REACH youth initiating SUD/COD treatment and/or recovery supports by the conclusion of the project