Opioids are a vital component in managing pain for surgical patients. However, they also pose a problem due to their addiction and potential for abuse. In this paper, I will discuss the rationale for opioid use, and its significant acute adverse effects, as well as complications contributing to their long-term use such as opioid-induced tolerance, and addiction. First, their mechanism of action, structures, method of use, and some terminology will be discussed. Understanding their mechanism of action on receptors helps us grasp a better understanding of their usage, and management of side effects. Next, we will compare the efficacy of the most widely used opioids along with antagonists for treating acute and chronic misuse of opioids. Finally, I will briefly go into multimodal analgesia strategies designed to lessen the use of opioids.