Unhealthy alcohol and drug use is especially problematic among parents because of the effects on children. To reduce the extent and negative consequences of unhealthy substance use, it is recommended that health care providers screen and briefly intervene for unhealthy substance use and provide treatment if use is problematic enough to be a substance use disorder. We find considerable scope for providers to increase these services, especially among black and Hispanic parents. Adopting policies proven to increase rates of these services and addressing known barriers to treatment could help many families with children.