Background: Those with chronic pain have worse drug and alcohol treatment outcomes and higher rates of relapse compared to those without pain or with reduced pain (Ilgen et al., 2020). Methods: A descriptive study was employed with the aim of determining what are the sensory processing pattens of those with co-morbid chronic pain and in recovery for substance use. All participants completed the Adolescent and Adult Sensory Profile, the Brief Pain Inventory, and the Personal Recovery Outcome Measure (PROM). Results: From the preliminary findings, individuals with co-morbid chronic pain and substance use may have atypical sensory processing in areas of sensation sensitive, sensation avoiding, and low registration, compared to the normative sample. Individuals within this clinical setting in general were not receiving non-pharmacological treatment for their pain. With pain fluctuating between mild (2.2/10) and severe (6.0/10) throughout the day. Results of the PROM were an average of 21/30. Item 21 states “I can manage stress”. From these findings a 5-week sensory based OT Group was implemented at a PHP/IOP treatment center focusing on self-management, health-management, and stress reduction strategies to improve overall occupational performance. A pain management OT Group is also included in the manual. Conclusion: Individuals with co-morbid chronic pain and substance use may have sensory processing patterns that are impacting function and recovery. This highlights the potential value of further research and consideration in clinical practice of these unique patterns and how they may be impacting recovery and long-term sobriety.