The proposed Virginia Screening, Brief Intervention, and Referral to Treatment (VA-SBIRT) project will be a statewide initiative that aims to develop and implement a sustainable model to increase provider training and statewide access to screening, prevention, early intervention, and treatment for substance use disorders with a focus on serving the Northern Virginia and Shenandoah Valley regions. The other three regions of the state will be afforded access to training, coaching and implementation tools. Virginia is a large and diverse state, with significant concerns around substance use that span its diverse geographic, socio-economic, and ethnic strata. VA-SBIRT's population of focus is adults 18 and over in Virginia primary care and community healthcare settings including those with and without health insurance being seen at emergency departments, county health departments, free clinics, federally qualified health centers, student health centers, and specialty clinics. VA-SBIRT's targeted specialty populations include a large student health population through three campuses at George Mason University (GMU) and patients being seen at the Prince William Health Department Sexually Transmitted Disease clinic, spanning three large, dense counties in Northern Virginia. Over the 5 year grant period, SBIRT interventions will be delivered statewide to a minimum of 20,000 unduplicated adults. In addition, GMU will develop a central data repository for all practice and referral sites. GMU will then facilitate connection to Virginia's health information exchange, ConnectVirginia, for all participating practice and referral sites.