The Louisiana State Opioid Response (LaSOR) 4.0 Program will enhance existing statewide prevention, treatment, and recovery support services for individuals with or at risk for opioid use disorder (OUD) and/or stimulant use and misuse disorder (SUM). Special populations to be served by this grant are (1) the under- and uninsured, (2) the criminal justice population, (3) pregnant people and infants, (4) tribal communities, (5) people who inject drugs, (6) colleges and universities, (7) youth including children and adolescents, and (8) veterans. While services will be delivered statewide, the focus will be on the areas with the highest overdose rates and the highest overdose volumes, in addition to areas with limited access to medications for opioid use disorder (MOUD) based on the LaSOR needs assessment. The goals of LaSOR 4.0 include 1) reduce opioid and stimulant-related deaths and incidents by implementing high-quality, evidence-based treatment services for individuals with or at risk for OUD and other concurrent substance use disorders, including transitional-aged youth and young adults (ages 16-25); 2) increase access to evidence-based harm reduction products and services for priority populations; 3) increase access to community recovery support services for individuals with OUD and/or SUM; 4) decrease opioid and stimulant use and misuse by supporting evidence-based prevention and education efforts for priority populations; and 5) decrease opioid and stimulant use and misuse within the Native American population by supporting engagement and education initiatives within tribal communities. Funds will support treatment services for 2,955 individuals, recovery support services for 2,499 individuals, and prevention services for 12,500 individuals. LaSOR 4.0 will enhance and expand MOUD treatment availability statewide by expanding the capacity of the Opioid Treatment Programs (OTP) and Office Based Opioid Treatment (OBOT) providers through a hub and spoke model. To optimize maternal access to OUD treatment and improve infant health outcomes, birthing hospitals across the state will implement best practices to support and enhance the care for substance-exposed mothers and newborns. OBH will continue to utilize a centralized harm reduction distribution hub which will allow organizations across the state to request harm reduction products, including naloxone, for distribution in their communities. To address the criminal justice population, OBH will continue to support MOUD treatment at jails and prisons, as well as reentering individuals with OUD and/or SUM at Oxford Houses. Recovery support services for individuals with OUD and/or SUM will be enhanced by supporting collegiate recovery programs with a specific focus on high-need populations. LaSOR will implement prevention evidence-based practices, including the Prescription Drug Abuse Prevention Module of Life Skills, Generation Rx, and Too Good for Drugs. To address the specific needs of veterans and their families, OBH will support an existing initiative by creating a media campaign to raise awareness regarding how opioids are impacting service members, veterans, and their families and available resources to combat this issue.