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Tribal Opioid Response Grants

The purpose of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Tribal Opioid Response Grant (TOR) is to address the opioid crisis in Tribal communities by increasing access to culturally appropriate and evidence-based treatment, including medication for the treatment of opioid use disorder (MOUD).
  • About the Program

    TOR seeks to reduce unmet treatment need and opioid overdose-related deaths through prevention, treatment, and/or recovery support activities for Opioid Use Disorder (OUD) and for stimulant misuse and use disorders. In Fiscal Year (FY) 2020, SAMHSA distributed approximately $50 million in TOR funding to 92 federally-recognized Tribes and Tribal organizations.

    View the award recipients:

    More information about TOR Grants.

    SAMHSA’s TOR program profile provides a means to share aggregate data collected from grantees in line with the Government Performance and Results Act of 1993 and continued under the Modernization Act of 2010. This program profile highlights selected, program-specific indicators that are available through SAMHSA’s National Outcome Measures (NOMs).

    More information about the Government Performance and Results Act (GPRA).

  • Treatment

    TOR grant recipients use funds to provide treatment at all levels of care and to fill gaps across the treatment continuum. Grantees implement outpatient, intensive outpatient, and residential treatment; individual and group counseling; and case management and referrals to other needed services. Grant recipients are also permitted to provide financial assistance to under- or uninsured clients to access OUD treatment.

    TOR recipients utilize evidence-based practices (EBPs) for the treatment of Substance Use Disorders (SUDs) including:

    • Screening, brief intervention, and referral to treatment
    • Cognitive-behavioral therapy
    • Dialectical behavioral therapy
    • Motivational enhancement
    • Motivational interviewing
    • Contingency management
    • Eye movement desensitization and reprocessing
  • Prevention

    TOR grant recipients conduct a range of activities aimed at preventing opioid misuse and overdose, including activities for elders, youth, and other community members to receive positive messaging, education, and training to increase their knowledge of opioids and other drugs.

    Grant recipients conduct prevention outreach and education efforts through in-person events, signs and billboards, social media, TV, radio, and other media.

    TOR recipients use prevention EBPs to conduct outreach and education with schools, Tribal leaders, and community members, including:

    • Red Cliff Wellness School Curriculum
    • PAX Good Behavior Game
    • Healthy Way of Living Model
    • Hidden in Plain Sight
    • Gathering of Native Americans (GONA)
    • American Indian Life Skills curriculum
  • Recovery Support Services

    TOR grant recipients provide support services to assist individuals with SUDs in their recovery. Grant recipients also provide wraparound and aftercare services including case management, transportation, childcare assistance, employment services, relapse prevention, nutrition programs, and sobriety activities.

    Recovery activities include:

    • Recovery coaching and peer support
    • Training and certification for individuals to become peer recovery specialists
    • Recovery housing
    • Recovery support groups
    • Traditional recovery practices
    • Referrals to vocational training and employment opportunities

    Cultural Practices

    In recognition of ancestral cultural knowledge, wisdom, ceremony, and practices of American Indian and Alaska Native Tribes, TOR recipients are encouraged to incorporate traditional approaches into their grant activities.

    Some common traditional practices include:

    • Sweat lodges
    • Talking circles
    • Traditional healers
    • GONAs
    • Teaching traditional values
    • Smudging
    • Traditional dance
    • Storytelling
    • Teaching of herbs
    • Drum ceremonies
    • Spiritual practices and prayer
    • Medicine wheel activities
    • Traditional craft making
    • Healing fires
    • Pow wow camps
    • Equine therapy
    • Wilderness expeditions
    • Teaching farming, hunting, and fishing skills

Past Events

An Introduction webinar for SAMHSA TOR Grantees was hosted on December 8th, 2023. In this webinar, presenters from the Opioid Response Network discuss technical assistance needs and processes for TOR grantees.

TOR Webinar: Introduction to the Opioid Response Network for TOR Grantees (44 minutes, 36 seconds)

If you have any questions about the TOR grant, please email SAMHSA’s Office of Tribal Affairs and Policy at

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