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US civilian, noninstitutionalized adults used prescription opioids in 2015, and prescription opioid misuse and opioid use disorder have become common. 2 Coinciding with increased opioid prescribing has been a resurgence in illicit heroin use and, more recently, illicitly manufactured fentanyl. Through these combined effects, the number of estimated opioid-involved overdose deaths in the United States increased 90%, from 25 052 in 2013 to 47 600 in 2017. 3 Beyond the health risks and harms associated with prescription opioid use, research has demonstrated that the promotion of more routine use of prescription opioids was not evidence based. For instance, a 2015 systematic review concluded that the “evidence is insufficienttodeterminetheeffectivenessoflong-termopioidtherapy” and that “evidence supports a dose-dependent risk for serious harms.” 4 A subsequent meta-analysis of 96 randomized clinical trials …