In many European countries the use of opioids for long-term treatment of non-malignant pain has dramatically increased during the last decade in order to improve the patient’s quality of life, to allow social activities and the return to work. Therefore, the issue of driving by patients regularly taking opioids, and its medico-legal aspects, concerns physicians, patients and society. Many studies explored the effect of opioids drugs on cognitive and driving skills using healthy subjects, patients taking opioids for chronic malignant and non-malignant pain, with different administration methods and in combination with other psycho-active drugs. These studies show that the patients taking stable dosages of opioids may continue working and driving safety. The decision to allow patients to drive under stable long-term opioid therapy is always individually based and should be founded on relevant and up-to-date clinical data, including both physical and mental evaluations. The patient, on the other hand, should also be responsible for his condition before and during driving.