With over 1,200 overdose deaths in 2015, opioid use disorder has reached epidemic levels in Kentucky. Addressing this epidemic is a top priority across all levels of government and public and private partners. While Kentucky has made great strides, much work remains. Guided by the Recovery-Oriented System of Care Framework, the purpose of the Kentucky Opioid Response Effort (KORE) is to implement a comprehensive targeted response to Kentucky's opioid crisis by expanding access to a full continuum of high quality, evidence-based opioid prevention, treatment, recovery, and harm reduction services and supports in high-risk regions. Informed by data on populations most in need, the KORE will focus on three primary populations: pregnant and parenting women, individuals re-entering society upon release from criminal justice settings, and adolescents and young adults. A composite risk index identified nine geographic regions at highest-risk for OUD including the greater Lexington area, the greater Louisville area, Northern and Eastern Kentucky. The KORE offers the state an opportunity to dedicate much needed resources to address five overarching goals: (1) preventing opioid misuse and abuse; (2) increasing access to OUD treatment services, including Medication- Assisted Treatment; (3) increasing the availability of recovery support services designed to improve treatment access and retention and support long-term recovery; (4) increasing availability of naloxone; and (5) enhancing statewide coordination and evaluation of healthcare and public safety strategies targeting opioid misuse and overdose. A comprehensive performance assessment system will support ongoing evaluation of progress against proposed goals, objectives, and activities and guide continuous quality improvement efforts. Though a multifaceted and complex response is necessary, Kentucky's singular focus is to end the opioid epidemic and to save lives!