TY - JOUR AU - A. Agnoli AU - R. Hoss AU - M. Kotova A1 - AB - This article outlines a public health-oriented framework to opioid stewardship in primary care, emphasizing safe prescribing, risk assessment, and treatment of opioid use disorder. It reviews evidence-based practices for managing chronic pain, mitigating overdose risk, and initiating buprenorphine in primary care. The article highlights the importance of individualized, patient-centered care, addresses barriers such as stigma and regulatory fear, and underscores the value of collaborative care models-including pharmacists, behavioral health, and peer support-to reduce opioid-related harms and improve outcomes. AD - Department of Family and Community Medicine, UC Davis, Sacramento, CA 95817, USA. Electronic address: aagnoli@health.ucdavis.edu.; UC Davis Health Department of Pharmacy, UC Davis, Sacramento, CA 95817, USA. AN - 41656020 BT - Prim Care C5 - Opioids & Substance Use CP - 1 DA - Mar DO - 10.1016/j.pop.2025.09.005 DP - NLM ET - 20251107 IS - 1 JF - Prim Care LA - eng N2 - This article outlines a public health-oriented framework to opioid stewardship in primary care, emphasizing safe prescribing, risk assessment, and treatment of opioid use disorder. It reviews evidence-based practices for managing chronic pain, mitigating overdose risk, and initiating buprenorphine in primary care. The article highlights the importance of individualized, patient-centered care, addresses barriers such as stigma and regulatory fear, and underscores the value of collaborative care models-including pharmacists, behavioral health, and peer support-to reduce opioid-related harms and improve outcomes. PY - 2026 SN - 0095-4543 SP - 51 EP - 62+ ST - Opioid Stewardship T1 - Opioid Stewardship T2 - Prim Care TI - Opioid Stewardship U1 - Opioids & Substance Use U3 - 10.1016/j.pop.2025.09.005 VL - 53 VO - 0095-4543 Y1 - 2026 ER -