Measures include Prescription of only small amounts (requiring frequent visits for refills) Urine drug screening to monitor treatment adherence (ie, to confirm that patients are taking the drugs and not diverting them) No refills for "lost" prescriptions Use of tamper-resistant opioid formulations that have been developed to deter abuse by chewing or by crushing and injecting oral preparations Consideration of a buprenorphine formulation that can be useful for analgesia and that has a ceiling effect on risk of sedation and respiratory depression—properties that make it an effective treatment for any opioid use disorder Clinicians may need to refer problematic patients to a pain specialist or a substance use specialist experienced in pain management.