An international panel of pain specialists including physicians and health policy scholars met to discuss the impact of fear of opioids on the clinical use of these strong analgesics. Recognizing potential risk from opioids, the panel members concluded that irrational fear of the drugs often impedes their appropriate use. The need for education among clinicians was recognized and the panel concluded that while progress has been made, much remains to be done to correct unfounded fears and misconceptions that impede provision of opioid analgesia when it is indicated.