The opioid & substance use epidemic has gained national attention, and there has been increasing pressure on hospitals, health systems and health plans to effectively tackle this complex issue. Chronic pain affects a large number of Americans, and ineffective practices related to prescribing guidelines, prescription monitoring and provider education have led to an increase in opioid & substance misuse/harm. hospitals, health systems and health plans must engage in efficient organizational strategies, enhanced provider education and safer prescription practices to effectively tackle the rise in opioid & substance use.