Chronic pain can be managed with both pharmacologic and nonpharmacologic options, such as behavioral and physical therapy. Unfortunately, insurance coverage for multidisciplinary pain management is limited, which places much of the responsibility for treating chronic pain on primary care and prescription medications. Multiple pharmacologic options are available, including nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and opioids, but it is rarely possible to predict the safest and most effective medication for a given patient. Moreover, there is a paucity of clinical trials to guide physicians in treating chronic pain. In some cases, opioids are the only class of medications to which a patient responds, but because of dangerous adverse effects, including respiratory depression, unintentional overdose, and addiction, it is important for physicians, especially those in primary care, to be confident with prescribing them safely.