Summary
PROJECT SUMMARY American Indians (AIs) have the highest rate of prescription opioid misuse of any sociodemographic group in the United States (US). Increasing rates of opioid misuse have led to increased prevalence of injection drug use (IDU) and concomitant overdose and infectious disease morbidity and mortality. Infectious disease burdens are driven in part by inadequate access to sterile injection equipment. IDU-associated harms are one of many drivers of AIs having the lowest life expectancy in the US. Few Federally recognized Tribes in the US have implemented syringe services programs (S
