The decision to prescribe opioids is rife with clinical and nonclinical factors that have legal and public policy implications. As a result, every clinical decision to prescribe medically necessary opioids is rife with implicit biases. These biases may be clinical or extra-clinical in origin. But in aggregate, these biases determine how critical decisions are made to continue or modify prescription opioids.Primary goal of the presentation is: To understand how biases affect clinical decisions, we must first study how these biases form, how we can become aware of them in real-time, and how we can account for these biases when making clinically appropriate decisions. The presenter will go through a series of clinical vignettes of patients with chronic pain who present to a clinic and discuss how certain biases form and how those biases affect the course of patient care. I will review the patient journey and dissect particular points along the journey where biases form and demonstrate how those biases affected the course of patient care. The educational strategies will deploy case based learning to educate participants on the role implicit biases play in opioid prescribing decisions.