The opioid epidemic in our country has understandably been given much attention. Here we discuss the prevalence of opiate use/addiction in population, present how the opioid crisis came about in the country, what’s helped address this problem and why this problem isn’t going away. We then look at what to look for when referring a patient to treatment providing a virtual Top 10 list of those things your treatment program should be doing to be successful clinically. Focus will include how to identify and select from among a wide array of practices, including technology-based practices, cognitivebehavioral treatments, and medication-assisted treatments, with substantial scientific proof of effectiveness. We will explore what to look for in staffing and curriculum to ensure the best outcomes. We will look at how to measure whether services are being delivered with fidelity by the right staff, to the right patients and how to evaluate their results. From experience in implementing staffing and evidence-based practices in over 250 public and private treatment programs, we show how all treatment systems can offer a cost-effective, evidence-based continuum of care.