Approximately three million US citizens have had or currently are diagnosed with opioid use disorder (1), while at the same time it’s estimated that 20.9% of U.S. adults (51.6 million persons) are living with chronic pain. (2) Many people living with Opioid Use Disorder (OUD) are taking prescribed and non-prescribed Medications to treat Opioid Use Disorder (MOUD) which may lead practitioners to presume their analgesic needs have been met. Worse, their medication may have been stopped, further complicating pain management. This may invoke fear in the medical practitioner due to lack of experience or education in caring for this vulnerable population, and fear in the patient that their pain won’t be adequately addressed. For patients presenting with managed or unmanaged Opioid Use Disorder the use of evidence-based guidelines for treating acute and chronic pain safely and effectively will prove useful to improving the patient experience. The old practice of stopping patients home MOUD, is just that- obsolete. Interrupting MOUD may lead to poorly controlled pain and place the patient at risk for returning to active use. In this course, Attendees will examine best practice in caring for people with pain and Opioid Use Disorder as well as review cases from a board-certified addiction medicine nurse practitioner who practices in a large academic medical center on the addiction consult team. Discussion will include reducing fear when MOUD is on the medication list and also if it’s been inadvertently stopped by the medical teams, to include case of a patient undergoing buprenorphine low dose induction. (1) Azadfard M, Huecker MR, Leaming JM. Opioid Addiction. [Updated 2023 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448203/(2) Rikard SM, Strahan AE, Schmit KM, Guy GP Jr.. Chronic Pain Among Adults — United States, 2019–2021. MMWR Morb Mortal Wkly Rep 2023;72:379–385. DOI: http://dx.doi.org/10.15585/mmwr.mm7215a1.