New Mexico State Opioid Response 4 (NMSOR4) - New Mexico (NM) will use SOR 4 funds to continue to address the opioid use disorder (OUD) crisis through implementation of evidence-based practices (EBPs) in prevention, treatment, recovery and harm reduction, including an innovative community defined evidence practice (CDEP) specific for tribal youth. Implementation model: NM SOR 4 will continue to expand its capacity to address OUD morbidity and mortality via the modified Hub and Spoke implementation model, called the Collaborative Hubs Model. This will support the adoption and implementation of EBPs statewide that have proven effectiveness to prevent, treat, support recovery and reduce harms related to OUD. Focal to the NM Collaborative Hubs implementation model is a strong diverse, multidisciplinary network of addictions experts (psychiatrists, family medicine, emergency medicine, toxicology, pharmacists, nurses, peer support supervisors and peer support workers, psychologists, etc.) that provide statewide training, implementation support and technical assistance across the entire workforce and in a wide range of treatment settings. This network includes the nationally recognized MOUD ECHO program and the NM Bridge hospital program. This includes education and support in English and Spanish for workforce in the use of psychosocial and therapeutic supports. It also includes focus on co-occurring physical, mental, and substance use disorders, special populations including youth, LGBTQ+, pregnant person, rural, Hispanic and Native American populations. Goals: SOR 4 will (1) Increase access to medications for OUD (MOUD) with added emphasis on youth in treatment, detention centers, and reentry populations. Expansion of telemedicine prescribing will be central to this effort. We will also expand low-barrier MOUD access in our state's public health offices, and increase access to intensive treatment and support for persons leaving emergency departments as well as those with high acuity in our Community Anchors triage centers; (2) Promote and support treatment that is comprehensive including FDA approved medications, therapy, psychosocial supports, and recovery; (3) Expand access to recovery services with a strong emphasis on recovery housing for persons in intensive outpatient treatment and placement/training of peers in various settings; (4) Expand access to prevention EBPs, as well as implementing a CDEP for tribal youth; (5) Expand harm reduction efforts by restructuring our naloxone distribution through use of regional hub centers and utilization of online reporting/ordering system and a heat map; (6) Ensure continuous quality improvement through quality data collection, reporting & evaluation. Additionally, NM SOR 4 will collaborate with NM's Tribal Opioid Response partners to reduce duplication of efforts and help collaboratively address NMs OUD crisis. We will target our media campaign programs to focus on building awareness of our expanded services, including youth-focused (16-25 years) treatment messaging. The GPRA tool will be collected on all individuals receiving treatment and recovery services with 350 persons annually engaging in treatment and recovery services who will complete the GPRA. We will reach 1050 persons over the life of the 3-year SOR 4 grant. Prevention numbers served include naloxone and direct prevention activities and will reach 45,000 persons per year for a total of 135,000 people over the life of the SOR 4 grant program.