Anesthesiologists and surgeons face challenges in providing patients optimal pain relief, minimizing opioid side effects, and prescribing appropriate amounts of post-discharge opioids. Anesthesiologists commonly use short-duration opioids, but longduration opioids such as methadone improve postoperative analgesia, reduce postoperative opioid consumption, and may enable reduced take-home opioid prescribing. Attendees will learn about the pharmacology and perioperative use of methadone. This paradigm shift in intraoperative opioid use can improve patient care, outcomes, and safety.