466 ajp.psychiatryonline.org Am J Psychiatry 168:5, May 2011 istration (FDA) initiated work in 2009 to establish a risk evaluation and mitigation strategy for opioids (9), which may require prescribers to periodically train and recertify using an opioid medication guide. Other requirements may include physician-patient agreement forms, patient counseling about individual opioid medications, and documentation of distribution by pharmacies.