For a study, researchers sought to look into the perceptions and experiences of emergency department (ED) patients about pain and emergency care to help build future psychosocial interventions that balance the need for acute pain management with the hazards of opioid exposure. From September 2020 to May 2021, qualitative, semi-structured interviews with 18 adult patients with acute pain were done after discharge from an urban, academic Level 1 trauma center ED. After the audio recording was transcribed, framework analysis was used to identify common themes. For cluster analysis of word similarity, thematic hierarchy was validated using Pearson correlation coefficients. The majority of the 18 participants were Black (n=11, 61%) and male (n=12, 66.7%). About 1 overriding topic emerged from the analysis: locus of control during an emergency pain encounter. Internal and external factors on pain management were recognized as having 4 themes: accessing treatment for acute pain; managing pain after discharge; obtaining opioids: self-medicating and misuse; and the opioid crisis causes individuals in pain to suffer. Unrelieved pain, factors influencing pain management, and obtaining opioids from non-medical sources were all reported by patients discharged from the ED. There was a substantial mismatch between patients and physicians regarding pain management priorities and the value of tailored care.