Many states have responded to the abuse of prescription opioids by developing a set of policies limiting access (e.g., prescription drug monitoring programs). While abuse is a continual concern, opioids play an important role in legitimate pain management: About one-third of the U.S. population struggles with chronic pain. This project will provide an initial, but in-depth look at the relationship between state opioid policies and pain management to determine how the many policy dimensions work together to affect pain in the Medicare population and if these policy effects differ for vulnerable Medicare enrollees in nursing home or hospice settings compared to the general Medicare population. State policies have the potential to affect pain outcomes by shifting access to treatment, costs of care, and patient and provider norms.