In this time during which the use of opioids for analgesia is being attacked by well-organized zealots, society is desperately seeking ways to make utilization of these medications safer and more effective. In a growing number of developed nations, genetic testing is being routinely utilized to determine which opioid is likely to provide the best choice for each patient. There have been excellent results reported in terms of prescription of the lowest possible dosage of an opioid with ideal analgesia--for individualized pain medicine. Unfortunately, the United States is lagging behind in pain pharmacogenomics, thereby perpetuating our 2 opioid crises: "abuse, overdose, and death" and "the swing of the pendulum to frank opiophobia and olioanalgesia." In the first part of this comprehensive symposium, a PharmD will discuss the science behind course descriptions pharmacogenomics. This will be followed by a neurologist who will discuss practice issues associated with this scientific approach to opioid prescribing. Finally, a policy and bioethics specialist will discuss the conundrum of gaining insurance coverage for this cost-efficient yet currently expensive paradigmatic revision, along with some of the myriad ethical issues associated with pharmacogenomic testing in practice as well as research.