Prescription opioid use continues to contribute to significant morbidity and mortality in the United States. Benefits can outweigh the risks when limiting opioid prescribing in some situations, however, rapidly decreasing or abruptly discontinuing long-term opioid analgesics can significantly increase the risk of adverse consequences, including opioid-related hospitalizations and emergency department visits.¹
To help clinicians reduce risks and improve outcomes related to opioid dose reduction and discontinuation among patients prescribed opioids to manage pain (particularly chronic pain), the United States Department of Health and Human Services (HHS) developed a Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics
The HHS guide and current guidelines emphasize that tapering should be individualized and should ideally proceed slowly enough to minimize opioid withdrawal symptoms and signs. The HHS guide includes key issues to consider when changing a patient’s chronic pain therapy, and it lists issues to consider prior to making a change and as a patient’s dosage is being tapered.
“Effectively tapering those taking chronic opioids is difficult. This difficulty has likely contributed to the nation’s current opioid challenges. This guide, promoting patient-centered, individualized treatment, is a tool clinicians can use to build a framework to best address these cases and provide effective care”. ~ Jayme Steig, PharmD, RPh, Quality Improvement Program Manager, Great Plains Quality Innovation Network.