Orthopaedic surgeons, the third-highest prescribers, have a crucial impact on the opioid epidemic, underscoring the urgency for safer prescribing protocols. To tackle this issue, ongoing research is dedicated to enhancing pain management and establishing evidence-based prescribing guidelines for shoulder surgeries. The literature on shoulder and elbow procedures provides vital foundational data for developing evidence-based opioid prescribing guidelines. Our strategy involves dispensing reduced quantities of opioids after surgery and prioritizing prescription refill requests over potentially excessive initial prescriptions. Recommendations are as follows: 1. collaborate with the anesthesiology team for perioperative nerve blocks 2. Use interscalene block for low-risk patients 3. Consider alternatives for high-risk patients 4. Utilize liposomal bupivacaine for postoperative pain control as an alternative to interscalene block.