The overarching purpose of this study is to provide pilot data towards a future larger grant proposal seeking to understand if patients undergoing TKA/THA can successfully taper off of or significantly reduce opioids prior to surgery when given information about the risks of using opioids prior to surgery and to determine how patients and providers respond to a “reminder” about the risk of elective surgery in the opioid exposed patient. To do so, this project will identify patients on opioids prior to arthroplasty and provide those patients and their provider’s with information about the benefits of tapering off opioids. Specifically, we will modify the HOT initiative to include the rationale for tapering opioids prior to arthroplasty and patients will be given this information in a letter and their provider will make a recommendation to taper. Patients enrolled in methadone maintenance programs, those taking buprenorphine for addiction management and patients receiving intrathecal opioid therapy will be excluded. Research staff will follow enrolled patients in order to better understand changes in opioid use prior to surgery and other outcomes in the pre- and post-operative period. Initial baseline assessments will take place when patients are seen in the orthopedic clinic and surgery has been recommended. Additional assessments will take within 1 week of surgery to assess if patients were actually tapered and longitudinally following surgery. This work will be complimented with qualitative data from focus groups with patients scheduled for a TKA and THA and providers involved in surgical interventions for pain.