Introduction: Constipation is the most common, bothersome symptom of opioid-induced bowel dysfunction.1 This study documents the impact of opioid-induced constipation (OIC) on the patient. Methods: The effects of OIC were evaluated using data from the National Health and Wellness Survey 2004, a comprehensive, annual, cross-sectional US and EU study. Data were collected from 2137 individuals in the USA receiving opioids for chronic pain and were analyzed according to those who reported OIC (n=300) and those who did not (n=1837). Pain severity was rated as mild, moderate, or severe; work productivity was evaluated using the Work Productivity and Activity Impairment Questionnaire, and HRQOL was evaluated using the Short-Form 8 (SF-8) health survey. Results: There were significant differences between the groups in terms of age (p<0.0001), race (p=0.013) and education (p<0.0001), but not in gender or income. Pain severity was significantly greater in individuals reporting OIC vs those without OIC (59% vs 48% with severe pain, p<0.0001). Individuals with OIC reported a higher percentage of work time missed (21.1% vs 18.8%), greater impairment while working (39.6% vs 36.7%), and greater overall work impairment (42.3% vs 40.2%). Activity impairment was significantly greater in individuals with OIC vs without OIC (65.6% vs 57.4%; p<0.0001). On both the mental and physical health components of the SF-8, mean scores were significantly worse in individuals with OIC vs those without constipation (42.5 vs 45.0; p=0.0002; 32.5 vs 34.4; p=0.0013). With the exception of work time missed and SF-8 mental component scores, significant differences were maintained when factors including age, gender etc. were controlled for using linear regression (pain severity was not controlled for). Conclusions: Chronic opioid recipients experiencing OIC have significantly more severe pain and impaired HRQOL compared with those without OIC. The presence of OIC also limits work productivity and patients' abilities to perform activities.