Pain represents the chief complaint for nearly half of all emergency department (ED) and outpatient clinic visits in the United States, and as much as it pains the first author to admit it (being a resident physician himself), residents are the frontline clinicians who encounter these patients. Despite available resources, residents often are ill-prepared to manage these patients, particularly in regard to the use of opioid analgesics. Compared to other providers, residents are more likely to overtreat abusers of opioid analgesics and refill opioid prescriptions more quickly. The reasons for this behavior deserve further scrutiny. In this Perspectives article, we ask why residents may be more likely to prescribe opioids for pain, and we provide recommendations for educational interventions to address this.