The opioid crisis is widely recognized as a difficult policy challenge but the reasons why it is difficult and the paths to overcoming those difficulties are less easily understood. As a result, policymakers risk spending limited public resources on potentially ineffective or even counterproductive efforts. Adopting the perspective of pay for success (PFS) – an outcomes-oriented funding model – helps to mitigate these risks and facilitates the application of sound public policy and administration principles. This, in turn, helps policymakers clarify challenges and implement more effective solutions to the opioid crisis. As outlined in this brief, policymakers can use these principles to enhance new or existing efforts to address the opioid crisis, regardless of whether the PFS financing mechanism is used to fund those efforts.