In the last 20 years, opioid use in the United States has increased drastically. As increasing numbers of opioid prescriptions have been written and dispensed, opioids have become more commonly accessible to adolescents leading to an increase in opioid abuse among America’s youth. Nearly 1 million adolescents report last-year opioid use in the United States, representing 3.6% of American adolescents. Substance use during adolescence can be harmful to healthy physical, cognitive, and social development and increases the risk of substance dependence in adulthood. Yet, rarely do adolescents seek help or recognize a need for substance use treatment. New intervention delivery methods such as those utilized in mobile health interventions have the potential to help address these barriers. Peer Network Counseling-txt (PNC-txt) is a brief text-messaging intervention based on Peer Network Counseling that is designed to address substance abuse issues by focusing on peer relations as the primary mechanism for behavioral change. PNC-txt is guided by five key Motivational Interviewing clinical issues: rapport, acceptance, collaboration, reflections, and non-confrontation. The intervention discusses substance use, values, beliefs, and plans, as well as their peer relationships. The purpose of this study is to test a text-delivered intervention designed to reduce risk for opioid misuse with adolescent patients and their parent or primary caregiver. We will conduct a randomized clinical trial of PNC-txt to determine the efficacy of the intervention in reducing risk for opioid misuse.