I have a 1999 CRV (2wd LX) with a check engine light throwing a P1381 code. I've followed the service manual steps to include checking for resistance through the CYP sensor, opens and shorts to the ECM, etc. Resistance is within limits (390 ohms through the sensor), and no shorts or opens. I don't have another distributor or ECM to swap out for troubleshooting. Also, the engine idles low and sometimes stalls out at red lights and stop signs. At one point I had a few other codes for individual cylinder misfires, P0301 - P0304, but it's not happening repeatedly.

Before I go buying a genuine honda distributor, which is what I fear I have to do, is there any chance this could be caused by something else like timing belt or just needing a timing adjustment? Also, I have not checked fuel pressure coming in and I was wondering if fuel delivery might be the cause of all this.

Thanks in advance for any advice.

As you suspected, you need to install a new genuine Honda distributor. They tend to last no more than 100,000 miles, anyhow.