Our goal is to generate new knowledge and develop new tools to reduce opioid misuse, opioid use disorder (OUD), and opioid related consequences among those with traumatic spinal cord injury (SCI). We will use a mixed methods approach, with quantitative and qualitative components. Self-report assessments will be obtained from 1600 participants from the SCI Longitudinal Health Study. The objectives are to identify the: (1) incidence of opioid use, misuse, and OUD, analyzing and adjusting for potential underreporting, (2) person and environmental predictors of opioid misuse and the development of OUD, and (3) relationship of opioid use, misuse, and OUD with health, participation, and employment. Participants will be drawn from an existing prospective cohort study, broken down into high, moderate, and low risk groups. Qualitative focus groups will identify barriers and facilitators to successful self-management and treatment based on the detailed experiences of participants with a history of opioid use to treat pain. Stakeholder and expert advisory panels will provide critical input to the design of the research, dissemination, and development of utilization strategies. Anticipated outcomes include new knowledge to guide policy, clinical practice, prevention, and self-management strategies to reduce opioid misuse, OUD, and related consequences for health, participation, and employment. We will develop and disseminate multiple products to promote the utilization of the study findings including: (1) individualized risk calculators, (2) guidelines for treatment and practice, (3) issue and policy briefs, and (4) research briefs and research alerts (lay summaries with recommendations). We will disseminate through multiple publications, presentations, webcasts, and newsletters. Data will be archived for public use.