Chronic opioid misuse puts people at significant risk for developing multiple health problems, caused either by decreased access to preventative care, exposure to blood-borne or sexually transmitted diseases or as a direct result of chronically elevated levels of exogenous opioids. People with opioid use disorder often suffer from chronic pain and mental illness at rates much higher than in the general population and are at significant risk for financial ruin, homelessness, overdose, and death. While it may not be possible to make opioid use completely safe, if we can, we should make it less dangerous. Illicit opioids are often impure and adulterated after production. They must be procured illegally and are often injected with unsterile equipment in an unsafe and unsupervised environment. All of these factors can and should be addressed as part of a comprehensive strategy to fight the opioid epidemic. Only by challenging the beliefs that underlie the stigma surrounding opioid use disorder and directly addressing the factors that contribute to the increased morbidity and mortality associated with chronic opioid misuse can we turn the tide of the epidemic.