Patients with opioid use disorder (OUD) present specific challenges for the clinician, particularly if they also suffer from pain, either acute or chronic. This activity outlines the diagnosis of OUD and reviews pain management options including non-opioid therapies and buprenorphine/naloxone, as well as the use of urine drug tests and referral to a treatment center. Through a longitudinal case example, this activity will illustrate examples of counseling for patients with OUD and pain.