Prescription drug abuse is an intentional misuse of a prescribed drug for recreational or other purposes that was not intended by the prescriber of the drug. Since 2012, fatalities from opioid overdoses have risen to approximately 17,000 per year in the United States. It is important for healthcare providers to follow a standardized guideline with patients receiving controlled substances, such as opioids, in order to prevent abuse. Within this project, a chronic pain management protocol was created, implemented, and evaluated in a selected critical access hospital’s emergency department and two rural health clinics. The protocol addressed the use of an online prescription drug monitoring program (PDMP) to identify patients who have a history of obtaining multiple controlled substance prescriptions and using multiple pharmacies to fill these prescriptions. In addition to using a PDMP, providers are educated in identifying risk factors of opioid use in their patients by using an evidence-based risk assessment tool. Opioid abuse prevention strategies and best practices for opioids prescribing are within the protocol. Strategies include pain treatment contracts and a stepwise approach to prescribing based on the patient’s report of pain, with opioids as the last resort. Other methods include urine drug screening, a nonjudgmental attitude from the provider towards the patient regarding abuse, and motivational interviewing methods to assist patients to stop abuse. Emphasis on other nonpharmacological methods are included, such as: physical therapy, cognitive behavioral therapy, counseling, yoga, biofeedback, and guided imagery. Evaluation of this protocol includes pre- and post-implementation surveys with the project stakeholders, including administrators and providers within the project hospital and clinics.