The State of Pain in America is a large and varied picture. To find a way to individually and collectively to support safe and effective pain management, we need to look at the history of pain management in the US Healthcare System.  This session will review some of the statistics and definitions that have informed legislative, regulatory and research actions in recent decades. Ms. Buckley will share portraits of how some people are currently accessing pain care. Current research efforts will be presented as a potential path forward to address both undertreated pain and substance use disorder.