Inclusion Criteria:

• * Enrolled in 1 of 3 primary care clinics associated with the Durham VAHCS, as evidenced by at least one outpatient PCP visit recorded in Managerial Cost Accounting (MCA) system.
• * Diagnosis of hypertension, hyperlipidemia, and/or diabetes mellitus in EHR (ICD-10 codes I10, E78.xx, and E11.xxxx) for at least one year.
• * Uncontrolled BP (indicated by average outpatient past year systolic BP of \>140/100mmHg). \> 1 measurement required.
• * Currently prescribed at least one oral medication for hypertension, hyperlipidemia, and/or diabetes mellitus as evidenced by at least one pharmacy refill within the previous year.
• * Most recent EHR AUDIT-C 5 (suggestive of alcohol misuse).
• * Self-reported access to any SMS text-capable phone.
• * Appropriate medication regimen for CVD prevention, screened by research coordinator and reviewed by Matt Crowley, MD (Mentor).

Exclusion Criteria:

• * Current enrollment in another trial for CVD risk reduction or medication adherence specifically.
• * Current participation in other alcohol misuse treatment programming.
• * EHR AUDIT-C suggestive of severe alcohol dependence requiring medical treatment, defined as 10-12 for both men and women.
• * Any recent or impending procedures that would warrant inpatient hospital stays or considerable changes to current medications (e.g., any changes other than altered doses).
• * Current palliative care or care through a nursing/hospice home.
• * History of clinically significant alcohol withdrawal symptoms, as evidenced by a score 10 on the CIWA.
• * Contraindicated medication regimen for CVD prevention, screened by research coordinator and reviewed by Matt Crowley, MD (Mentor).