There is an ethical obligation to relieve the pain and suffering in newborn infants. Opioids have been demonstrated to blunt the physiologic effects of pain and may prevent some of the clinical consequences of unmanaged pain. There are sufficient data to recommend the clinical use of opioid analgesics for the treatment of pain in the neonate. Neonates exposed to opioid analgesics can experience adverse effects. Adverse effects can be minimized by the use of various drug administration techniques and close monitoring. Further research is needed to determine how to optimize their effects. Data on the long-term effects of neonatal opioid exposure are warranted.