Cherokee Tribal EMS plans to implement a multi-faceted approach to combat substance use diseases and overdoses on the Qualla Boundary. We will do this by community engagement, stigma reduction, naloxone distribution, provider education, and treatment retention strategies. These will all be accomplished in a culturally sensitive manner respecting the Cherokee indigenous population. We will measure CPR/First Aid participants, naloxone administrations, medication assisted therapy participants, and overall suspect drug related illnesses. We anticipate serving over 800 participants each year with a total estimation of 3,275 served over the next 4 years.