The current study collected qualitative feedback from patients and parents to refine content and format of an evidence-based parent and child brief intervention targeting substance use (SU) and acute pain coping among adolescents with SU undergoing wisdom tooth extraction. Semi-structured, individual interviews were conducted with adolescents (M age= 18.9; SD= .94; 70% female-identifying) who self-reported past-year SU and have upcoming oral surgery (N=15) OR experienced past year oral surgery (N=15) as well as parents/ caregivers (N=20). Transcripts were double coded for thematic analysis. Adolescents (in the pre- and post- surgery groups) and parents were generally enthusiastic and receptive to an intervention that co-targets pain and SU before oral surgery. Learning about medication and non-medication pain management strategies and how SU after surgery can impact healing were identified by many as the most helpful proposed content areas. Opinions varied regarding taking opioids for post-surgical pain. Suggested intervention changes included: shortening the session length, making parent involvement optional, and using alternative language than “intervention” (i.e. “program”). Considerations for effectively engaging adolescents in conversations about their SU in the perioperative context were shared. Lastly, the modified pre-surgical brief intervention (for evaluation in a pilot RCT) will be discussed.