Date of Award

Spring 5-31-2026

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Briony DuBose, PhD, MDI, RN, LSSB

Abstract

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM National Practice Guideline was transcribed into a checklist format. The sample size of 20 patients was gathered over four weeks and followed through three total visits. Checklist completion scores were determined preliminarily, then after visits 1, 2, and 3.

Results: By the third visit, 100% of patients achieved complete checklists. While a significant portion of patients were clinically stable, others needed more support, and the checklist helped identify personalized care gaps, including Naloxone access, nicotine cessation counseling, mental health referral, SDOH support, and consistent comorbidity screening. Repeated checklist use promoted stronger continuity of care.

Conclusions: Implementing a comprehensive OUD checklist in primary care standardizes care delivery and ensures patients receive essential resources. Future applications may be most effective in settings with patients newer to outpatient OUD management and sites with integrated care coordinators. Further studies should explore long-term outcomes such as treatment retention, patient satisfaction, and relapse reduction across diverse primary care settings.

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