With increasing emphasis on effective pain management in clinical care, there has been a significant increase in the number of opioid prescriptions in the past decade.  While these drugs are effect in treating chronic pain, they also have a high potential for addiction and abuse.  Given this paradigm, it is increasingly important to identify patients at risk for abuse, misuse or diversion of these drugs.  There are several clinical risk assessment tools available, but these are dependent on accurate self-reporting by the patient. Urine drug testing provides an objective measurement that can be used to supplement clinical presentation and survey tools for risk assessment, and has become a vital part of pain management practice.  This presentation will discuss challenges in pain management, review available survey tools for risk assessment, and then give an overview of opportunities and challenges in laboratory support for pain management patients.