As psychiatrists see more referrals for substance use disorders, we examine their role in managing pain. Carlos Blanco, Eric Collins, Alla Landa, Martin Cheatle, and Ivan Montoya weigh in on common pitfalls, alternatives to opioids, and a framework for treating pain. You can learn more about substance use disorders and medication-assisted treatment at https://www.psychiatry.org/patients-families/addiction. Information about the Providers’ Clinical Support System for Medication Assisted Treatment is at www.pcssmat.org. Funding for this initiative was made possible (in part) by Providers’ Clinical Support System for Medication Assisted Treatment (1U79TI026556) from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. Music: "Sidecar" by Podington Bear