Patient Inclusion Criteria:  Had a primary care visit in a participating clinic during the active implementation period or sustainment period Screened positive for substance use on the day of the visit or in the prior year Adult aged 18 years or older at time of visit  Clinic Inclusion Criteria:  - At least 1 clinician trained in the use of reSET/reSET-O  Patient Exclusion Criteria:  - Patients who have requested through their health system to opt out of research  Clinic Exclusion Criteria:  - Previously participated in a pilot implementation of reSET/reSET-O