Every day, more than 90 Americans die as a result of opioid overdose (NIH, 2017a), and opioid overdoses have quadrupled since 1999 (CDC, 2016). Opioids are best described as a class of drug that includes synthetic versions, such as fentanyl, the commonly known illegal drug, heroin, and prescribed medications such as oxycodone (OxyContin®) and hydrocodone (Vicodin®; NIH, 2017b). Opioids directly activate the analgesia, or pain relieving portion of the brain as well as the reward region (Volkow & McLellan, 2016). This makes the drug effective for reducing pain as well as giving the body a sense of reward. However, the drug manipulates the reward system by building a learned association between taking the drug and the satisfactory effect received from the drug (Volkow & McLellan, 2016). This learned association puts the patient or user at risk for misuse of the drug, making opioid prescribing difficult for physicians. Other factors affecting opioid prescribing are racial disparities, patient-physician mistrust, pain perception, and the difference between acute and chronic pain (Mathur, Richeson, Paice, Muzyka, & Chiao 2014; Volkow & McLellan, 2016). The purpose of this article is to explore the factors that affect physicians’ decisions to prescribe opioids, and to examine how prescription trends influence the opioid epidemic.