Polysubstance Use Disorder Frequently in Medicine / Internal Medicine — 30yo Man | Psychiatry | SMLE Q#11528

SMLE Question #11528

Medicine / Internal Medicine Psychiatry

Objective: OBJ-253

Last updated: February 2026
A 30-year-old man with a history of polysubstance use disorder presents frequently with severe low back pain and repeatedly requests early opioid refills. He provides vague and inconsistent details about symptoms and prior evaluations. When not being observed, he appears comfortable and ambulates without limitation. Physical examination shows no objective findings to account for the reported pain. Which of the following is the most likely diagnosis?

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