Complex Pain and Substance Use Disorder brings together pain science, addiction medicine, and mental health to manage overlapping drivers of suffering—nociplastic pain, trauma, mood/anxiety disorders, and polysubstance exposure. This page turns evidence into integrated care: distinguishing undertreated pain from opioid use disorder (OUD), sequencing non-opioid multimodal analgesia, and aligning behavioural strategies with medication choices that minimize misuse and sedation. If you’re comparing options like a pain and addiction conference, you’ll find stepwise pathways for acute, subacute, and chronic presentations across outpatient, ED, peri-operative, and inpatient settings. Because goals differ—harm reduction, function gain, or dose stabilization—we emphasize shared decisions, sleep/circadian repair, and realistic pacing. For medication stewardship and safety, see Pain and Opioids Stewardship, which complements this page with formulary, taper, and monitoring detail.

Real-world results hinge on precision and continuity. Begin with a functional assessment that maps activities, sleep, and mood; screen for PTSD, depression, and anxiety that amplify pain and relapse risk. Use non-opioid foundations—NSAIDs/acetaminophen, adjuvants for neuropathic components, topical agents, physio and graded activity—then layer CBT for pain, acceptance/commitment approaches, pacing, and flare plans. Where OUD is present or risk is high, prioritize MOUD and avoid sedative stacking; if opioids are used, apply time-limited, lowest-effective dosing with clear agreements, PDMP checks, and overdose planning. Coordinate peri-operative care for patients on MOUD, and provide rapid re-entry pathways after setbacks so momentum is not lost.