The Confederated Tribes of Grand Ronde is comprised of approximately 5,500 members which 3,358 members living in Oregon and 1,916 members living on historical tribal land. While the Tribe has a small satellite office in Portland the Reservation and most of the member population is in the three southern counties, Polk, Yamhill and Marion with the greatest concentration in the Grand Ronde – Willamina area on both sides of the Polk-Yamhill county line. Through IHS, Federal grants, and State funding, the Tribe can provide limited behavioral health and substance abuse services. As mentioned above, significantly higher rates in poverty, education, and employment, continue to be reported. These reports reveal deeper needs which have been directly impacted by the past termination of the Tribe’s federal recognition in 1954, historical trauma, and other socioeconomic factor. The Tribe is currently unable to meet the disproportioned strains of addition, abuse, poor health outcomes, lack of education, widespread unemployment, and poor mental health when robust substance abuse and behavioral health services are not provided as part of the continuum of care to members. The Tribe’s goal for Tribal Opioid Response is to decrease opioid use and second to prevent fatal and non-fatal opioid overdoses within the Tribal community by implementing evidence-based programs, MAT best practices, and emphasizing culturally based curriculums. The Tribe seeks to fulfill the following objectives: Objective 1: By the end of the 60th project month, the Tribe will have successfully provided opioid use disorder and/or substance abuse disorder treatment for at least 225 patients. Objective 2a: By the end of the 24th project month, the Tribe will have arranged one comprehensive peer support training for currently certified peer recovery specialists and those pursuing certification. Objective 2b: By the end of the 60th project month, the Tribe will have arranged an additional comprehensive peer support training for currently certified peer recovery specialists and those pursuing certification, totally two trainings by the end of the period of performance. Objective 3: By the end of the 60th project month, the Tribe will have successfully distributed at least 250 units of naloxone to patients and the community. Objective 4: By the end of the 60th project month, the Tribe will have successfully 50 clients with through targeted outreach and enrollment assistance with the Oregon Health Plan. The Tribe will undertake the required and allowable activities for this grant: Provide treatment in federally and state-regulated Opioid Treatment Programs; train peer recovery specialists and/or recovery coaches following the guidelines required in each state or jurisdiction; purchase and distribute naloxone; provide assistance to patients with treatment costs and develop other strategies to eliminate or reduce treatment costs for under- and uninsured patients; and other activities including reporting on activities, progress on objectives, and data elements indicating the impact of our project.