The State Opioid Response (SOR) grant is distributed by the Substance Abuse and Mental Health Services Administration (SAMHSA) to the Virginia Department of Behavioral Health and Developmental Services (DBHDS). SOR funds were disbursed to the 40 Community Services Boards (CSBs) across the state, five Federally Qualified Health Centers (FQHCs), and several other grant partners. The OMNI Institute (OMNI) has worked with Virginia to implement a comprehensive evaluation across prevention, harm reduction, treatment, and recovery, and prepared this report to highlight the second year of SOR activities (October 2019 to September 2020).