According to MDPH’s most recent opioid report, there were 2,290 confirmed and estimated opioid-related overdose deaths in 2021, an estimated 185 more deaths than the prior year and above the previous peak of 2,110 deaths in 2016. While increases in drug overdose deaths in Massachusetts continue to trend lower than nationwide figures, they mirror a return to historically high rates driven in large part by public health challenges related to the COVID-19 pandemic, and an increasingly poisoned drug supply, primarily with fentanyl. With SOR funding the Massachusetts Department of Public Health (DPH), the applicant organization, will serve individuals affected by the opioid crisis including individuals who use stimulants, specifically targeting these high risk populations: Black, Indigenous, and people of color (BIPOC), LGBTQIA+, individuals who have experienced a prior nonfatal overdose, youth and families impacted by the opioid crisis, persons with history of incarceration, pregnant and parenting women, individuals experiencing homelessness, individuals at risk of contracting and/or currently living with infectious disease, people who use stimulants alone and/or with other drugs, and persons with co-occurring mental health disorders. MA DPH will ensure that funds are directed at the most marginalized populations and address systemic racial and ethnic disparities in access to SUD services. We seek to serve 14,975 (note: 8,975 are GPRA eligible) individuals annually over the two-year project period through implementing the following activities: 1) Prevention and intervention services for youth and families; 2) Overdose prevention and harm reduction services including Post Overdose Support Teams to outreach to people who have overdosed; 3) Opioid Treatment Program (OTP)/Office-Based Opioid Treatment (OBOT) enhancements to increase access for target populations; 4) Expansion of opioid and stimulant treatment access initiatives such as Hub and Spoke/Collaborative and Transitional Models of Care and Stimulant Treatment and Recovery Team programs; 5) Programming targeting pregnant and parenting women and their families that includes wrap-around supports, peer recovery coaching, and access to MAT; 6) Recovery supports including rapid rehousing, and the Access to Recovery program which facilitates client choice by providing voucher-based options and life skills training to support recovery goals; and 7) Expansion of developmentally appropriate recovery supports for youth and young adults. We also propose to: 8) Enhancements to existing state data analysis and reporting capabilities and improvements to web-based platforms to disseminate timely and accurate information to address the opioid crisis; 9) Implementation of wide-spread workforce development capacity building and training activities targeting a variety of sectors and audiences; and 10) Development and expansion of strategic communication and media campaigns targeting high-risk populations and high-need geographic regions in the Commonwealth to increase knowledge about addiction, decrease stigma, and improve awareness on how to prevent overdose and how to access treatment and recovery supports and 11) implement ongoing needs assessment and strategic planning to inform activities. We anticipate the MA SOR grant activities will improve, expand, and enhance access to opioid and/or stimulant use disorder¿treatment,¿prevent¿overdose, and¿support sustained recovery¿to¿achieve life-saving results.