Chronic pain is associated with significant morbidity and mortality. It is also associated with increased rates of depression, poorer self related health and increased risk of suicidality (2-4). Poor self-rated health has been demonstrated to be a predictor of increased morbidity and mortality (5-7). Tang and Crane (4) demonstrated that persons with chronic pain have a risk of death by suicide twice that of controls and that the lifetime prevalence of suicide attempts was 5-14%. Chronic pain impairs sleep (8) and may be related to abnormal immune function (9-11). As well, there is morbidity and mortality associated with medications used in the treatment of chronic pain. Although opiate medications form a significant part of the pain management armamentarium they are also associated with serious morbidity including sedation, respiratory depression, death and addiction. Death rates from these medications have risen dramatically (12) in recent years. Ives et al (13) report a 32% incidence of opiate misuse in an academic pain management unit. Cicero et al (14) reported that prescription opiate misuse is more common in rural, suburban and small urban areas, similar to the geographic background of Nova Scotia, and concluded that regionally specific risk minimization strategies should be developed.