OBJECTIVES: Opioid-induced constipation (OIC) is a common gastrointestinal side effect of opioid treatment that can lead to alteration or discontinuation of opioid therapy. This multinational cross-sectional survey assessed OIC burden of illness. METHODS: Health care providers (HCPs) and a sample of their patients prescribed opioids for chronic noncancer pain were surveyed regarding patient laxative use, OIC symptoms, treatment patterns, and OIC impact on patient’s pain management/daily life. RESULTS: HCPs (n=63) and patients from Canada (n=64), France (n=60), Germany (n=60), the United Kingdom (n=60), and the United States (n=60) participated. Sixty-nine percent of patients were characterized as inadequate responders to laxative treatment (used laxatives on ≥4 days in past two weeks and had continued constipation symptoms or symptom resolution with laxative side effects). Inadequate responders were more likely to have started an opioid regimen in the last six months and to have ≤1 bowel movement (BM)/wk versus ≥2 compared with responders. The proportion of patients self-reporting the following common gastrointestinal symptoms were higher than what physicians reported as the percent of their patients complaining of these symptoms: few normal or spontaneous BMs (88% vs 65%), hard lumpy stools (87% vs 71%), BMs different than normal (82% vs 59%), bloating (78% vs 71%), and abdominal discomfort/stomach cramps (75% vs 62%). Patients reported taking opioids less often (53%) or lowering the dose (57%) as a strategy to alleviate constipation, whereas HCPs reported recommending these strategies to approximately 10% of their patients with OIC. Approximately 40% of patients reported that constipation made it quite a bit harder or extremely harder to live with their chronic pain. CONCLUSIONS: Results indicate a disconnect in the frequency that OIC symptoms are experienced by patients versus perceived by their treating HCPs and also in the frequency of opioid dosing alteration to alleviate OIC by patients versus recommended by their HCPs.