Among 85 inpatients treated for alcohol and/or drug dependence, 52 % reported that pain triggered a relapse of their substance dependence. Low and middle intensity pain (2 and 3 on the five-point Melczak’s scale) were the most important in this respect. Before treatment, most patients reported using a very limited number of strategies to cope with pain (1.4 on average), suggesting that patients may benefit from instruction in applying techniques to cope with pain. These techniques are in many respects similar to techniques to cope with drug/alcohol craving. During in-patient treatment, the patients’ self-confidence to cope with pain increased. After treatment, patients reported their intent to use several pain coping strategies; the most frequently reported strategies were distraction, suitable physical exercise, relaxation, medical care, lifestyle changes, and autosuggestion. Abuse of alcohol and other addictive substance s may initially alleviate pain but later on they often aggravate it. The interactions between analgesics (including NSA) and alcohol are extremely risky. The experience of pain directly or indirectly related to substance dependence can be utilized as part of motivation enhancement therapy in the treatment of addiction.

Key words: pain – substance dependence – coping