The article entitled "Risk Evaluation and Mitigation Strategies (REMS) for Extended-Release and Long-Acting Opioid Analgesics: Considerations for Pain and Palliative Care Practice" that appears in this issue of the journal addresses the important new Food and Drug Administration (FDA) REMS program. This commentary expands on themes introduced by Dr. Gudin, projects future directions for REMS, and discusses possible benefits, limitations, and risks associated with the extended-release long-acting opioid REMS.