Both adolescent substance use AND other behavioral health concern(s)

MODERATE evidence of increasing difficulties at home, in school and/or in the community.

SEVERE (youth at high risk of adverse outcomes including injury, criminal justice involvement , school drop out, risk of drug overdose event, any opioid use; high risk of out-of-home placement or returning to community from placement)

Opioid misuse

Substance misuse primary, behavioral acting out secondary

Behavioral acting out primary, substance use secondary