According to the Centers for Disease Control and Prevention, prescribers should evaluate risk factors related to opioid use prior to initiation of opioid medication. The practice problem in this DNP project was that providers failed to consistently assess patients with complaints of pain for risk of opioid misuse and/or abuse prior to initiating opioid medication. An opioid risk-assessment screening tool (ORAST) has the potential to identify patients at high risk for opioid misuse and/or abuse. The purpose of this Doctor of Nursing Practice project was to identify and introduce an ORAST and then develop a policy to guide providers in its use in an ambulatory care clinic. Rosswurm and Larrabee's model for evidence-based practice served as the framework that helped guide project development. Evidence in the literature review supported The Opioid Risk Tool (ORT) as the most appropriate tool for the clinic. An 11-member project team voted unanimously for the ORT and to develop a policy to guide the use of the tool in the clinic. The ORT and its policy were evaluated by the team using the AGREE II Instrument. The team agreed that the ORT and its policy should be implemented into their practice setting (64% strongly agreed and 36% moderately agreed). A summative evaluation supported the Doctor of Nursing Practice student leadership of the project. Use of an ORAST has the potential to create positive social change by reducing the number of prescribed opioid by assisting providers in determining a patient's plan of care based on the patient's level of risk for prescription opioid misuse and/or abuse. Patient outcomes may be improved through reduction in opioid misuse and/or abuse.