"Opioids are the gold standard for the management of moderate to severe pain. In spite of its high efficacy, the clinical use of opioids is limited because of co-morbidities associated with its prolonged use. The last decade has seen a significant rise in opioid use in the United States resulting in a subset of the population developing opioid tolerance. Opioid-induced analgesic tolerance, defined as a decrease in anti-analgesic response following repeated or high dose morphine administration, potentiates drug dependence, addiction, overdose, and respiration depression. Chronic opioid use is also associated with increased length of hospital stay and higher readmission rates and even death. Therefore, it is imperative that we identify opportunities for improvement and delineate specific pathways for the care of chronic pain patients that are on opioids.