SAMHSA Tribal Opioid Response

Briefing Sheet

Background

• The Tribal Opioid Response Program (TOR) was first authorized in 2018 along with the 

State Opioid Response Program (SOR) under Title II Division H of the Consolidated 

Appropriations Act, 2018. All grants and sub-awards made under this announcement 

were governed by 45 CFR Part 75.

• The purpose of the TOR program is to assist in addressing the overdose crisis in Tribal 

communities by increasing access to treatment of opioid use disorder (MOUD), and 

supporting the continuum of prevention, harm reduction, treatment, and recovery support 

services for opioid use disorder (OUD) and co-occurring substance use disorders. 

• The TOR program also supports the full continuum of prevention, harm reduction, 

treatment and recovery support services for stimulant misuse and use disorders, including 

for cocaine and methamphetamine. 

• The TOR program emphasizes the use of medication-assisted treatment using one of the 

three FDA-approved medications for OUDs.

• The TOR program encourages the use of traditional practices.

• The TOR grant project period is two years.

Eligibility

• Funding for the TOR program is limited to federally-recognized American Indian or 

Alaska Native Tribes or tribal organizations. Tribes and tribal organizations may apply 

individually, as a consortia, or in partnership with an urban Indian organization. 

• Applicants can not apply for funding in consecutive years. Applicants can apply for 

funding every other year.

Funding

• Since its inception in FY 2018, the TOR program has used the user population estimates 

from Indian Health Service (IHS) as the basis for determining grant award amounts.

• In the FY 2018 and FY 2019 TOR Notices of Funding Opportunity (NOFO), SAMHSA 

listed all 574 Tribes and the amounts of funding for which they were eligible. In FY 2018 

SAMHSA funded 134 Tribal grantees totaling approximately $50 million. In FY 2019, 

SAMHSA funded 30 Tribal grantees totaling approximately $20 million.
• In the FY 2020 and FY 2021 TOR NOFOs, SAMHSA listed 5 tiers of funding levels 

based on IHS user population estimates (see table below). In FY 2020, SAMHSA funded 

92 Tribal grantees totaling approximately $50 million. In FY 2021, SAMHSA funded 40 

Tribal grantees totaling approximately $20 million.

FY 20 TOR Funding Table

User Population Funding Amount

1-5,000 $125,000

5001-10,000 $200,000

10,001-20,000 $50,000

20,001-40,000 $700,000

40,001+ $1,800,000

• In FY 2022, SAMHSA used a 4-tiered funding table and raised the amount of funding in 

each tier, maintaining the methodology of basing funding amounts on IHS user 

population estimates. In FY 2022, SAMHSA awarded 102 Tribal grantees totaling

approximately $55 million.

FY 22 TOR Funding Table

User Population Funding Amount

1-10,000 $250,000

10,001-20,000 $475,000

20,001-40,000 $825,000

40,001+ $1,925,000

• SAMHSA did not release a TOR NOFO in FY 2023 due to limited funds.

• SAMHSA conducted Tribal Consultation on the funding methodology for the FY 2024 

TOR NOFO on November 9th, 2023.

• Some funding factors under consideration include:

o Alternative data sources to the IHS user population as the base for service needs.

o Awarding based on need with respect to opioid use disorder or overdose rates.

o Awarding each TOR grant recipient, the same amount, similar to other SAMHSA 

discretionary grant programs.

o Some combination of the above methodologies.

• SAMHSA is also considering lengthening the project period from two to three or five 

years.