 We use a brief screener to identify youth at high-risk for drug or alcohol abuse. The CRAFFT was developed by Knight and colleagues to screen youth for alcohol and other drug use and is a mnemonic based on the six questions it asks. The CRAFFT is comprised from items from the RAFFT Riggs and Alario, 1989, DAP Drug and Alcohol Problems Klitzner et al., 1987 and POSIT Problem Oriented Screening Instrument for Teenagers Rahdert, 1991. The CRAFFT is brief, highly correlated with the Personal Involvement with Chemicals Scale PICS, a criterion standard r .84, and is practical for use in a primary care setting as it takes only a few minutes to administer Knight et al., 1999. The measure includes the following YesNo questions: 1 have you ever ridden in a car driven by someone including yourself who was high or had been using alcohol or drugs?, 2 do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?, 3 do you ever use alcohol or drugs while you are by yourself alone?, 4 do you ever forget things you did while using alcohol or drugs?, 5 have you ever gotten into trouble while you were using alcohol or drugs?, and 6 do your family and friends ever tell you that you should cut down on your drinking or drug use?. The six items have a cut-off score of 2 or greater with a sensitivity of 92.3 and specificity of 82.5 for long-term treatment need as identified by PICS scores Knight et al., 1999. We use a cut-off of 1 or greater, reflecting a less stringent criterion for high-risk that includes adolescents with potential problems who could benefit from a brief intervention in the primary care setting. 