Appropriate opioid prescribing includes prescribing sufficient opioid medication through regular assessment, treatment planning, and monitoring to provide effective pain control while avoiding addiction, abuse, overdose, diversion, and misuse. To be successful, clinicians must understand appropriate opioid prescribing, assessment, the potential for abuse and addiction, and potential psychological problems. Inappropriate opioid prescribing may involve not prescribing, under-prescribing, overprescribing, or continuing to prescribe opioids when they are no longer effective. These concerns are particularly prominent in patients with chronic pain. To make the challenges even worse, chronic pain patients often develop opioid tolerance, significant psychological, behavioral, and emotional problems, including anxiety and depression related to under or overprescribing opioids.

Clinicians who prescribe opioids face challenges involving medical negligence in either failure to provide adequate pain control or risk of licensure or even criminal charges if perceived they are involved in drug-related diversion or misuse. All providers that prescribe opioids need additional education and training to provide the best patient outcomes and avoid the social and legal entanglements associated with over-and under-prescribing opioids.