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The population bears a huge psychological, social and financial burden due to chronic pain and with its comorbidities it further adds to this burden. There are high rates of co-occurrence of depression and substance abuse, which are often overlooked. Therefore, patients presenting with pain or depression or substance abuse or a combination of these need to be evaluated thoroughly for the presence of the others. We report a case of a patient with primary complaints of pain and depressive symptoms with opioid and benzodiazepine abuse for over 16-18 years and discuss the neurobiological linkage between the three comorbid conditions.