The RWJBarnabas Health (RWJBH) Institute for Prevention and Recovery (IFPR) will implement the SAMHSA FY 2021 Screening, Brief Intervention and Referral to Treatment (SBIRT) project to provide SBIRT services for RWJBH patients ages 12 and older and to expand and enhance the continuum of care for substance use disorder (SUD) services. New Jersey has struggled with the substance use crisis in the last decade, with a 125.0% increase in the number of drug overdose deaths from 2013 to 2018. RWJBH's catchment area primarily consists of urban and suburban locales in New Jersey. It is racially and ethnically diverse, with less than half (48.4%) of the population being non-Hispanic white. Approximately one-quarter (22.7%) of the population is Hispanic/Latino, 15.2% is Black or African-American, and 11.0% is Asian. The goals of the SBIRT program are to: 1) institute a comprehensive education and training program to educate clinical staff on protocols and best practices of SBIRT; 2) increase screening and brief interventions for individuals with SUD and those at risk for developing SUD ; 3) evaluate the impact of SBIRT in the emergency department, inpatient, and outpatient settings on patient and system outcomes; and 4) create a sustainable SBIRT implementation project for the emergency department, inpatient, and outpatient settings. The project will utilize five evidence-based practices-SBIRT, SBIRT Training of Trainers, HIlton Adolescent SBIRT, SBIRT-Mobile Health and telehealth interventions, and Systems-Level Implementation of SBIRT-to effectively assess and intervene with patients displaying moderate to high risk behaviors for SUD. The project proposes to serve 2,250,000 unduplicated individuals in Year 1, 2,500,000 unduplicated individuals in Year 2, 3,000,000 unduplicated individuals in Year 3, 3,000,000 unduplicated individuals in Year 4, and 3,000,000 unduplicated individuals in Year 5. 3,000,000 unduplicated individuals will be served over the entire project period. The project will measure progress towards goals and objectives by utilizing RWJBH's shared electronic health record, the GPRA tool, and a partnership with RTI International, which has conducted three national cross-site evaluation of SAMHSA's SBIRT program over the last two decades and will serve as the project's Evaluator.