The B.E.A.R. Program consists of five federally recognized American Indian Tribes in Central Oklahoma: The Wichita and Affiliated Tribes, The Apache Tribe of Oklahoma, The Fort Sill Apache Tribe, The Caddo Nation, and the Delaware Nation. We seek to serve about 200 American Indian people for treatment services and reach over 5,000 in prevention in Caddo, Kiowa, and Washita counties of Oklahoma in total over the lifetime of the project. Our goal is to prevent opioid misuse and encourage local doctors to become certified in Medication Assisted Therapy (MAT). Our three counties are classified by the Oklahoma Department of Health as medically underserved and Mental Health Professional Shortage Areas. There are no substance abuse treatment or assessment centers and no accessible practicing psychologists or psychiatrists. American Indian people must now travel one hour or more each way to Oklahoma City for behavioral health care. Poverty among American Indians is severe and about twice that of Whites in two of our three counties including Caddo county which contains 85% of our target population. No systematic effort to assess the behavioral health of our American Indian people, or to provide them with substance abuse prevention or treatment services, has ever been accomplished in the three-county area. We propose to begin by conducting assessments of each counties’ readiness to support efforts to reduce opioid abuse and provide access to behavioral health care that is responsive to our cultural traditions and locally available. Based on these assessments, we will work to provide strategic opioid misuse evidence-based prevention services and begin to create Tribal partnerships with three small local hospitals to provide Medication Assisted Therapy (MAT). In addition to providing information about opioids to our American Indian people, we seek to provide them with increased knowledge of their language and traditions in the form of culture classes. Our culture classes will be structured to appeal to youth seeking their American Indian identity and elders who wish to share their traditions. Culture classes will highlight culturally appropriate wellness and a drug free lifestyle. Our grant goals are simple: Create a Strategic Plan, develop an American Indian Workforce, Implement Strategies that Work, Reduce Death by Opioid Overdose, and Use Culturally Appropriate Practices.