The opioid epidemic in the United States has become a public health crisis, which continues to worsen. The purpose of this monograph is to help obstetrician-gynecologists develop a perioperative framework with which to identify patients at risk of dependence and addiction and to describe a multimodal approach to postoperative pain management using the pathways of enhanced recovery after surgery. Preoperative counseling and optimization of comorbid medical conditions, comprehensive patient education, and optimal postoperative management also will be reviewed.