This lecture will trace changes in prescribing methods over the past 40 years that may have, unintended, led to excessive narcotic prescribing, one of the causes of the current opioid epidemic. Dentists prescribe over ten percent of the immediate release narcotics in the U.S.A., and perhaps a greater percentage of initial opioid prescriptions. As a result statutory changes in regulation of narcotic prescribers and prescriptions have been promulgated in many states, including Connecticut, and include dentists. Non-opioid alternatives can be quite successful in controlling dental related pain and should be considered in most cases. Pre-emptive analgesia with combinations of long-acting local anesthetics and non-steroidal anti-inflammatory medications has led to significant decreases in immediate and long-term pain perception.