Flandreau Santee Sioux Tribal Opioid Response - The Flandreau Santee Sioux Tribal Health Center (FSST HC) Opioid Response program will operate on the Flandreau Reservation in Moody County, South Dakota, to continue building upon the success of a sub-award received from the Great Plains Tribal Opioid Response (GPTOR) in 2022-2024. Over 5 years, the FSST HC Behavioral Health department will provide preventative, treatment, harm reduction, and recovery services to the Flandreau Santee Sioux Tribal (FSST) community. The provided services will include: specialized training to FSST tribal community members and FSST staff in identifying opioid misuse and administering medications in the event of an overdose. Additional training provided for FSST membership to establish peer and other support groups. A public health vending machine will be installed to create ease of access to substance testing strips and medications. Finally, FSST HC will design an Equine program, or horse therapy, to aid in treatment and recovery services to the FSST AI/AN population. For these services, the project staff will work with tribal leadership and community members to provide and incorporate the most culturally appropriate healing activities. This will include directions on such things as: smudging, drum circles, storytelling, etc. As transportation can be a barrier for accessing services, FSST HC will provide transportation for program participants to attend: Opioid treatment facilities, recovery or other support groups, and the Equine program. The intended impact from the project includes increasing the sobriety rate of the program participants by 20%, developing a Flandreau reservation based equine program to aid in cultural and ceremonial based healing, and educating FSST community members on Opioid and stimulant misuse, harm reduction, stigma, and the lasting impact of generational trauma