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The prevalence of substance use among patients presenting to primary health care settings mandates clinical competency in the area for nurse practitioners (NPs). An educational intervention with an evaluation component is described. The effect of incorporating substance use content into a Family Nurse Practitioner (FNP) curriculum was tested with a convenience sample of 16 FNP students and 8 practicing NPs. Students’ knowledge increased significantly; however, differences in students’ and practicing NPs’ knowledge did not reach significance. Students’ clinical competency increased significantly, as demonstrated by standardized patient clinical evaluations, and was significantly better than the practicing NPs in the skill domains of evaluation and record keeping. Educational intervention can improve NP identification of substance-abusing patients in primary health care settings.