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This study determined the frequency of problematic substance use and of counseling about drug and alcohol use among 867 women and 320 men who reported symptoms of depression in managed primary care clinics. Seventy-two (8.3 percent) of the women and 61 (19 percent) of the men reported hazardous drinking; 228 (26.3 percent) of the women and 94 (29.4 percent) of the men reported problematic drug use, including use of illicit drugs and misuse of prescription drugs. Only 17 (13.9 percent) of the patients who reported hazardous drinking and 18 (6.6 percent) of those who reported problematic drug use received counseling about drug or alcohol use during their last primary care visit. Men were significantly more likely than women to have received counseling about drug or alcohol use from their primary care practitioner.