Patients discharged from an urban ED after presenting with acute pain from fractures, renal colic, or musculoskeletal back injuries appear to receive little communication from ED providers regarding opioid dependence or alternative pain management options. A survey of these patients found that those with negative experiences from their pain management described deficiencies in communication that lead to misunderstanding of clinical diagnoses. They also reported fragmentation of care among their providers and a desire to be involved in decisions made about their pain management.