Abstract: The present study determined the association between identifying as American Indian/Alaska Native (AI/AN) and ever having had an opioid-related overdose, housing status, prior diagnosis of a psychiatric illness, and utilization of syringe service and drug checking services. We recruited and surveyed people who use drugs in community-settings using targeted samplings methods in eight Oregon counties (N = 468). We conducted logistic regression analysis to assess whether AI/AN people had higher odds of opioid overdose. We found that the adjusted odds of ever having had an opioid related overdose was significantly higher for AI/AN people (Adjusted Odds Ratio = 2.23; 95% Confidence Interval [CI] = 1.24, 4.02) compared to non-AI/AN people. These findings suggest the need for policies and interventions that prioritize access to culturally informed substance use disorder treatment and harm reduction services to reduce disparities in opioid-related overdoses among AI/AN people.