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Best practices in outpatient opioid stewardship include a consistent framework: baseline and periodic risk assessment (e.g., validated tools, history of substance use), PDMP review at initiation and at defined intervals, and an opioid treatment agreement outlining expectations, safe storage, and refill policies. Co-prescribing naloxone for patients on higher morphine milligram equivalents or with risk factors improves safety without implying misuse. Documenting measurable functional goals (sleep, activity, participation) guides dose adjustments and tapering decisions. Urine drug testing can be used judiciously. Rigid visit requirements (Option C) may limit access; telehealth with periodic in-person assessment can be risk-stratified. Skipping PDMP checks (Option A) contravenes safety standards and many state regulations. Avoiding naloxone (Option D) contradicts harm-reduction principles. APRNs should integrate multimodal analgesia, monitor for adverse effects, and coordinate with palliative care and behavioral health, balancing analgesia with function and safety while meeting documentation and regulatory expectations.