PURPOSE. To identify the common patient barriers regarding analgesic use; to describe the influence of patient barriers on pain assessment, patient adherence to analgesic therapy, and pain outcomes; and to describe clinical approaches that address patient barriers. DATA SOURCES. Healthcare literature. DATA SYNTHESIS. Patient barriers to analgesic use include fear of addiction and tolerance, concern about side effects and medication ineffectiveness, desire to be a good patient and to avoid distracting the physician from curing the disease, fatalism, fear of injections, forgetfulness, reliance on nonpharmacologic therapies, stoicism, concern that pain indicates disease progression, and meanings attributed to the pain. CONCLUSIONS. Patient barriers significantly influence analgesic use and pain and quality-of- life outcomes. IMPLICATIONS FOR NURSING PRACTICE. Identifying patient barriers to analgesic use is an important nursing consideration. Patient barriers influence pain reporting of pain, adherence to analgesic therapy, and quality of life. Early assessment and intervention for these barriers are essential, and may be effective in ensuring adequate analgesic use and in identifying appropriate nonpharmacologic pain therapies.