Although opioid therapy is widely used for the treatment of chronic pain conditions, there is a lack of consensus on a number of practical issues related to the use of prescription opioids. The authors conducted a comprehensive practice-oriented survey to examine physicians' attitudes, knowledge, experience, and practice patterns regarding opioid therapy for chronic pain management. The survey was conducted during 2007 and 2008 through nationwide direct mails and e-mails to physicians who are currently practicing in the United States. The survey contained 23 questions divided into six categories: (1) physicians' overall view on opioid therapy for chronic pain management; (2) clinical indications for opioid therapy; (3) patient-related factors influencing the decision to begin opioid therapy; (4) effectiveness of opioid therapy; (5) choice of opioid regimen; and (6) opioid agreement and opioid abuse behavior. The survey results suggest that opioid therapy remains as an important treatment option for chronic malignant and nonmalignant pain. However, the survey results should be viewed in the context of a low response rate (18.2 percent). These results also suggest that by improving the clinical knowledge of physicians participating in opioid therapy through education and collaboration, including a team approach with consultation from pain specialists, psychologists, and others, a better outcome for opioid therapy in patients with chronic pain conditions could be achieved.