FEAR OF ADDICTION to opioid analgesics affects their use in the treatment of pain by physicians, nurses, and the lay public. Imprecise terminology and regulations has led to confusion between the image of the street addict and the patient with pain. Commonly cited definitions are presented, and a comparison of the street addict and the patient with pain is offered. Similarities and differences in terms of increasing medication requirements, tolerance, withdrawal, intoxication, and lifestyle are described. The nurse's unique position and role in influencing the continuing distinction of these terms and the subsequent treatment of the patient with pain based on this distinction are discussed.