From 1999 to 2019, opioid-only mortality rates increased from 2.8 to 15.8 per 100¿000 (p<0.001) for American Indian/Alaska Native (AI/AN) women and 4.6 to 25.6 per 100¿000 (p<0.001) for AI/AN men in the U.S. During the same time period, the AI/AN population also exhibited significant increases in mortality rates due to opioids in combination with other substances (i.e., alcohol, benzodiazepines, and methamphetamine), where all opioid-related mortality rates increased significantly (p<0.001) from 5.2 to 33.9 per 100¿000 AI/AN persons. Similar behavioral health disparities are witnessed among the AI/AN population in New Mexico. The AAIHB TOR Project has been designed to address the opioid overdose crisis in tribal communities via a collaboration of a tribally designated organization, the Albuquerque Area Indian Health Board, Inc. (AAIHB), and four of its six Consortium Tribes – Jicarilla Apache, Mescalero Apache, Ramah Navajo, and To’Hajiilee Navajo. The overarching purpose of the AAIHB TOR Project is to support the continuum of prevention, recovery, and harm reduction services for opioid use disorder (OUD) and co-occurring substance use disorders among AI/AN youth and adults. Project goals and measurable objectives are aligned with the foundational elements, priorities and strategies of the National Tribal Behavioral Health Agenda, and include the following core components: 1) training, certification a mobilizing a cadre of AI/AN peer support workers in all 4 participating tribes; 2) developing and disseminating culturally centered strategic messaging products; 3) facilitating community trainings on naloxone use, Mental Health First Aid (MHFA), Question Persuade Refer (QPR), Trauma-Informed Care, Adverse Childhood Experiences (ACE), and/or Social Determinants of Health (SDOH); 4) facilitating Project Venture courses with AI/AN youth; 5) disseminating naloxone within the participating tribes; and 6) reviewing and enhancing existing tribal harm reduction policies/practices in all four participating communities. At least three Evidence Based Practices into this effort – Project Venture (PV), Mental Health First Aid (MHFA), and Question, Persuade and Refer (QPR). These selected EBPs are appropriate for the proposed outcomes, have strong evidence, and have a history of successful implementation with diverse communities in New Mexico, including tribal communities. The AAIHB TOR Project is therefore well positioned to strengthen prevention, recovery, and harm reduction activities among AI/AN youth and adults throughout our region to engage tribes, create awareness of OUD and prevention pathways, increase access to harm reduction practices, and enhance recovery support for affected individuals and families that are currently experiencing substantial behavioral health disparities.