This is a renewal of a study in which we examioned barriers and facilitators to intervening with alcohol and drug (AOD) problems for adolescents in primary care (PC). The behavioral health fields have failed to persuade primary care providers (PCPs) and health systems to implement Screening, Brief Intervention and Referral to Treatment (SBIRT) protocols for adolescents despite a growing literature that demonstrates effectiveness of SBIRT. We build on the findings of our parent study to examine implementation and effectiveness of two modes of delivery of SBIRT. We propose to randomize pediatric primary care providers to 3 study arms 1) a Usual Care control arm, 2) an intervention arm where SBIRT is delivered by the PCP, and 3) an intervention arm where SBIRT is delivered by a Behavioral Health Clinician (BHC). Both the PCPs and the BHCs will be trained in an empirically supported brief intervention to reduce AOD problems and refer to CD treatment when needed.