Sisseton-Wahpeton Oyate Tribal Opioid Response Program - The Tribal Opioid Response Program will be implemented on the Lake Traverse Reservation, homeland to 14,806 enrolled citizens of the Sisseton-Wahpeton Oyate. The aim is to enhance service delivery for medication for opioid use disorder (MOUD) and/or other substance use disorders treatment, increase access to opioid overdose reversal medications, decrease mortality from drug overdoses, promote education of first responders and key community members about opioid and/or stimulant and other co-occurring substance misuse, and raise community readiness. Located in extreme northeast South Dakota, the Reservation shares geography and checkerboard jurisdiction with 7 counties in South and North Dakota and Minnesota. The population of focus is 6,806 American Indians users of the Sisseton Indian Health Service. The population is young: 48% under age 24. Focus is young adult relatives, ages 25-34, who comprise 16% of the user population and represent 70% of Roberts County fatal overdoses for years 2012-2021. The project will provide intensive Recovery Support Services to 175 unduplicated relatives by providing care coordination per the Chronic Care Model, an evidence-based practice that contributes to effective MOUD treatment. It will provide Harm Reduction Services to 1,310 community member relatives through community-level opioid overdose prevention education training and naloxone rescue kit access information and/or distribution (OEND). Other harm reduction supplies, such as test strips for fentanyl and Xylazine detection, will be provided according to community readiness and demand. Another aim is to combine mainstream medicine and treatment by MOUD and per the American Society of Addiction Medicine alongside indigenous best practices. Cultural connectedness with personal harmony and balance between is a vital social determinant for American Indian people. The award will fund two full-time employees, a Community Health Worker Care Connector and Project Manager/Data Specialist. Project goals: 1. Engage 150 relatives for care connection services per culturally informed and responsive Community Health Worker service plans that are referred by and overseen by Sisseton-Wahpeton Oyate Asniyapi Clinic medical providers who prescribe MOUD. 2. Accept referrals of 25 relatives that are referred for care connection services by MOUD medical prescribers other than the Tribally-operated clinic who provide and clnically oversee the Community Health Worker service plans . 3. Participate in development of a community of practice -- a system that will better-integrate, track, and document the collaboration and warm hand-offs between medical and psychosocial treatment providers, peer recovery, criminal justice, and resources who comprise the recovery support team for each relative we collectively serve. 4. Implement opioid overdose prevention education training and naloxone rescue kit access information and/or distribution (OEND), as well as education and distribution of other harm reduction supplies that are requested in the community. 5. Promote advancement of workforce and community readiness for clinically managed MOUD and culturally informed and responsive harm reduction practices through community education and outreach, public health surveillance, and active participation in SWO Health / Tribal Action Plan (TAP) activities, including development in CY/2024 of the successor TAP for 2026-2030.