CARE2HOPE was established in 2017 through the National Rural Opioid Initiative. CARE2HOPE has since inspired several spin-off projects in rural Kentucky and has been nationally recognized for its impact on communities. The goal of CARE2HOPE is to improve the health of rural Kentuckians by working with communities to develop comprehensive approaches to address harms related to substance use and to support the health of people who use drugs. As of November 2023, more than 600 study participants and more than 90 community coalition and board members have been involved in CARE2HOPE projects. CARE2HOPE projects are ongoing and still enrolling new participants. Participation in CARE2HOPE projects is strictly confidential, with all records protected by a Federal Certificate of Confidentiality.