Dr. Jane Liebschutz is an academic physician in general internal medicine/primary care with experience studying health effects of interpersonal violence using both qualitative and quantitative methods. She seeks a K23 award to become a leader in the development of treatment approaches for persons with co-occurring substance use disorders (SUD) and post-traumatic stress disorder (PTSD) in the primary care setting. To advance her goals, she will also focus on chronic non-cancer pain, a condition both associated with SUD and PTSD and a common clinical presentation of patients with these conditions in the primary care setting. As part of her K23 award, she will conduct a cross-sectional study of primary care patients with chronic non- cancer pain to describe the prevalence of co-occurring SUD and PTSD and treatment needs. (AIM 1) Using qualitative research methods, she will conduct a focus group study of primary care physicians to explore preferences for primary care based interventions for patients with co-occurring SUD, PTSD and chronic pain. (AIM 2). She will utilize information gathered in these two projects in conjunction with established behavioral therapies for patients with SUD and PTSD to develop a multi-disciplinary behavioral intervention for co- occurring SUD, PTSD and chronic pain for the primary care setting. (AIM 3) Career development activities for this award include mentoring by individuals with extensive research experience in addiction, dual diagnosis and PTSD, directed readings, graduate level coursework, immersion in specialty settings (PTSD training center, substance abuse treatment program, pain rehabilitation program), attendance at specialty conferences, and the research itself. Completion of the proposed work will prepare Dr. Liebschutz to independently investigate the treatment of co-occurring substance use disorder and PTSD in the primary care setting.