Abstract Background: The nationwide opioid crisis is having a significant impact on the U.S. population. Patients may turn to alcohol and opioids for pain relief, which can lead to cancer, alcoholic liver disease, and heart disease. Providers can improve outcomes by screening patients for alcohol use prior to getting an opioid prescription using the Audit-C screening tool. Purpose: This DNP Project started formal screening for alcohol abuse in a small rural pain clinic with five hundred patients per month. Methods: During the first visit, patients were triaged by the nurse and screened using the AUDIT-C tool and had a urine drug screen performed. A nurse specially trained in the Audit C screening tool discussed education on alcohol, opioids, and the results from the screening tool with the patient on the 1st and 2nd visit. Results: 16 participants were screened in a three-month period with 68.8% screening negative for alcohol and 31.3% positive. Out of those positive for alcohol, only two of those patients were followed for three months. Conclusion: The mixing of alcohol and opioids together increases the risk of overdose and contributing to the already high number of deaths that are associated with substance abuse and alcohol abuse related deaths nationwide. Despite limitations, the project has enhanced the understanding of the AUDIT-C tool within the pain clinic and the importance of its use. The providers now have access to important information that can assist in a proper treatment plan and referral if needed.