The term “the “plot thickens” means that a situation is becoming more complicated, more involved, or more intricate. These words accurately describe the impact of “opioid litigation” on the Main Street Practitioner, and yet cannot fully describe the unintended consequences resulting from an all-out legal assault on the physician-patient relationship. Patients to the left. Practitioners to the right. And the great divide brought on by opioid litigation creates the “stuck in the middle” experience physician-patient relationships undergo because of bad actors (every profession has them) and the lawyers and regulators who play a role in sorting out this mess despite not treating people for a living. Small victories emerge, however, as the healthcare system begins to understand the complexity of underlying medical and mental health conditions that are screaming for attention, and which may merit the use of controlled substances. Do you have a voice in writing the next chapter in this story? Absolutely! This lecture is designed for all Main Street Practitioner who wish to be heard, along with their patients, in learning how to avoid being a pawn in a story often written by those who do not have all the facts and to navigate a system that often includes vague directives and insufficient tools to tackle medico-legal expectations. Attendees will examine case examples to identify valuable “lessons learned” and similar takeaways to assist in documenting valid controlled substance prescriptions while preserving the physician-patient relationship and avoiding ongoing fall-out from the unintended consequences of opioid litigation.