African Americans (AA) experience a disproportionate burden of cancer pain. The purpose of this study is to describe adherence to around the clock (ATC) oral opiates for AAs being treated for cancer pain. Using a cross sectional descriptive approach, self-identified AAs (n=85) 21 years or older, diagnosed with cancer, and taking an oral ATC opiate were recruited from a tertiary cancer center and a safety net hospital in Atlanta. Mean age was 56 years (range 35-87), 58% were women, and 48% had at least some college education. Participants had various cancer diagnoses, with 75% receiving cancer treatment in the last month (57% chemotherapy, 11% radiation, and 32% both). Mean pain at its worst, average, and least was 6.1, 4.8 and 2.9 respectively; all in the last 24 hours and on a 0-10 scale. Patients were prescribed either extended release Morphine (62%), extended release Oxycodone (34%) or Methadone (4%). Self-reported adherence showed that 54%, 56%, 59%, and 51% reported taking the ATC opiates as prescribed (correct dose at the correct time) for the past 1, 2, 3, 4 days respectively. They reported last skipping a dose in the last week (37%), last month (17%), or last 2 to 3 months (13%). Only 33% said they never skipped a dose. Of those who reported skipping a dose, the most common reasons included not feeling like they needed it (33%), sleeping through dose time (27%), not being at home (25%) and being busy (25%). Other concerns for not taking opiates as prescribed included, concerns about relying on medicines, not wanting to take medicines unless the pain was severe, and drowsiness. Findings from this study enhance understanding of how ATC opiates are taken by AA and provide information on which to develop interventions to improve cancer pain management. Supported by NINR 1K01NR014673.