The Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids for chronic pain (1) recommend the following: Limiting total daily oral morphine milligram equivalents (OMME) to < 50 when possible Considering the individual harm / benefit ratio at doses > 50 OMME daily When possible, avoiding doses > 90 OMME daily Weighing the needs for analgesia and functional improvement against the risks of higher-dose therapy before justifying daily doses > 90 OMME Tapering and then stopping opioid therapy if the goals for pain relief and functional improvement are not met or if maintaining them requires dose escalation Buprenorphine or methadone should be prescribed only by clinicians trained in the unique qualities and risks of these drugs.