A large body of literature from the United States describes aberrant (i.e. use other than as prescribed) medication-related behaviours among pain patients, and the extent to which they are associated with harm (1-4). To date, these clinical tools have not been tested and validated in Australian clinical populations. This paper (i) reviews the aberrant drug behaviour literature and (ii) describes the development of an aberrant drug behaviour scale for use in multiple healthcare settings in Australia.