A nurse is caring for a client who has a history of substance use disorder and is experiencing moderate pain. What is the most appropriate nursing action regarding pain management for this client?

Rationale: A. Clients with a history of substance use disorder are at risk for undertreatment of pain due to provider or nurse concerns about dependence. Pain management should be based on clinical assessment and patient-reported pain, using prescribed analgesics while closely monitoring for efficacy, side effects, and potential misuse. This approach ensures adequate pain relief without stigmatization or undertreatment. B. Withholding pain medication based solely on a history of substance use is unethical and unsafe. It can lead to unnecessary suffering, withdrawal, or escalation of pain-related stress, and does not address the immediate need for pain relief. Psychiatric evaluation may be helpful for comorbid conditions, but it does not replace pain management. C. This is unsafe because it discourages honest communication, may result in inadequate analgesia, and does not reduce risk of dependence in a controlled, clinically monitored setting. Pain should always be assessed and treated objectively. D. Non-pharmacological strategies (e.g., heat, relaxation, physical therapy) can be adjuncts but are not sufficient for moderate to severe pain. Complete reliance on these methods may result in untreated pain and unnecessary suffering.