The United States is in the midst of an addiction crisis. Wyoming faces a pressing need for increased access to addiction care services. The lack of adequate resources has led to a rising number of individuals struggling with substance use without the necessary support. Wyoming ROOTS aims to transform emergency departments into key intervention points - ensuring sustained patient engagement in treatment, increasing access to medications for MOUD, and overall strengthening Wyoming’s addiction care system. Although substance use disorders (SUDs) have traditionally received less attention than other medical conditions, there is a clear and urgent need to provide evidence-based medical care for patients with the disease of addiction, lest we lose more persons unnecessarily to a treatable disease.