Use of prescription painkillers has increased in staggering proportions compared with other medication classes, in terms of the number of prescriptions written, costs and incidence of overuse and abuse. It has been noted that adherence to guidelines for instituting and monitoring opioid therapy can have a significant impact on cost control in managing the care of an injured worker. The earlier in the claim that insurers are alerted to problems, even to the point of predicting cases in which potential exists, the easier it is to ensure improved outcomes. This white paper will review red flags to look out for and how to identify risk earlier when opioids are used in a patient's therapy.