Opioid analgesics are well recognised in the therapy of refractory chronic pain. From the researches in pain management in Saudi Arabia, it is stated that this country has highly restrictive policies regarding pain medication. However, the objective was to develop evidence-based guidelines in opioid therapy for adults chronic pain among the patients in Saudi Arabia. Opioid analgesics are paramount in chronic pain management among the adults. The therapy was considered to be effective, especially when the patient had no history of drug abuse. However, development of practice guidelines as the code of conduct and critical examination of the patient's chronic pain is important in determining the appropriate opioids for those patients.