Adolescent substance use disorders are common illnesses that will be encountered in the primary care setting. Though they have been decreasing in prevalence recently, they still manifest in significant public health costs and increase the chance for negative life outcomes. When identification and intervention occur at an early stage, many of the long-term consequences may be mitigated. Thus, identifying, preliminarily treating, and referring to subspecialty treatment when necessary are an important skillset for the primary care provider.