Tapering opioid therapy: clinical strategies

[...]of thumb, the longer the patient has taken opioids, the longer the tapering process must be. [...]the decreased pill burden with long-acting products actually supports the tapering strategy of reducing the patient's pill intake. In a study of 140 chronic pain patients with opioid use disor...

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Bibliographic Details
Published in:Pain management (London) 2018-11, Vol.8 (6), p.409-413
Main Authors: Pergolizzi, Joseph V, Rosenblatt, Melanie, Mariano, Dean J, Bisney, John
Format: Article
Language:English
Subjects:
Analgesics
Comorbidity
Disease control
Disease prevention
Drug dosages
Family medical history
Narcotics
opioid
opioid epidemic
opioid withdrawal
Pain
Pain management
Patients
tapering
tapering opioid therapy
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Summary:[...]of thumb, the longer the patient has taken opioids, the longer the tapering process must be. [...]the decreased pill burden with long-acting products actually supports the tapering strategy of reducing the patient's pill intake. In a study of 140 chronic pain patients with opioid use disorder (pain for 9.6±8.4 years), 27.9% could be successfully tapered off opioids and were reported opioid-abstinent for 1 year (15). [...]we cannot prejudge patients with opioid use disorder. Withdrawal symptoms As a rule of thumb, the daily dose of opioids needed to prevent the symptoms of acute withdrawal is about 25% of the previous day's dose (17). [...]opioid tapering plans should avoid decreasing the dose by more than 75% in a single step.
ISSN:1758-1869
1758-1877
DOI:10.2217/pmt-2018-0040