Opioids not infrequently raise a variety of controversies. One of these is the risk of opioid dependence: it is not uncommon for patients to be reluctant to use opioid analgesics despite experiencing even very severe pain. The risk of opioid dependence is indeed present, but in practice it does not necessarily arise in connection with the use of opioids as painkillers - so who becomes dependent on opioids, what are the manifestations of dependence and what is the treatment for opioid dependence?