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Objective
Findings/Key points
A large proportion of people who use substances also live with untreated chronic pain. People who use substances and their families often point to the lack of appropriate pain care as a contributor to their substance use and an impediment to successful treatment and recovery. Efforts to address opioid-related harms have led to serious and unintended consequences for some people living with chronic pain, including unmanaged pain, increased stigma, reduced access to care for people who use opioids for pain relief, and preventable deaths. This has led some people to obtain illicit drugs to self-medicate, putting them at serious risk of overdose. Despite widespread decreased opioid prescribing, and investments in a continuum of harm reduction, treatment, and prevention initiatives, there are record high numbers of overdose deaths in Canada. We must urgently address untreated pain as a driver of this crisis.