Skip to main content

Help, Let Me Out! Tapering Patients Off Of An Opioid Regimen

Are you a chronic pain patient who has been on opioids for a long time?  Or maybe a physician who has patients like this?  As you might know, there is no magic formula for "getting off" of an opioid regimen.  The risks of long term use of opioids is quite clear. In addition, after a period of use, the
effectiveness of an opioid regimen seems to diminish.




One thing is for certain.  If a patient has been on an opioid regimen for an extended period of time, an abrupt discontinuation can lead to withdrawal symptoms. That is certainly not a good plan of action!
So, how can a patient find their way off of one of these treatment regimens in a healthy way?

Here are some suggestions based on a lecture at the World Congress of the World Institute of Pain in May 2016:

1) For patients on multiple opioid regimens, decrease long acting opioids first. This way the patient still has the shorter acting opioids available if necessary.

2) Go slowly.  Reduce dosage of remaining opioids by 10 to 20 percent of initial dose each time. The interval between reductions can occur as rapidly as every 5 to 7 days. However, if a patient has been on an opioid regimen for an extended period of time--years--the intervals may be a month apart. This Provides the patient time/opportunity to learn other strategies to cope with pain.

3) Once the patient is at 30 percent of their original opioid dosage, the author suggests reducing remaining dosage by 10 percent per week.

4) Keep in mind that it in order to succeed, it is necessary for the patient to learn alternative pain management methods during the withdrawal period.  Cognitive Behavioral Therapy may also be of benefit during this time.

You can read additional information about this topic by clicking here.


Sources: PracticalPainManagement; Wikimedia

Comments

Popular posts from this blog

Living with Chronic pain hits the big screen!

Been to the movies lately?  Jennifer Aniston is on the big screen in a recent release titled "Cake."
Her character, Claire is a victim of chronic pain...she belongs to a support group, where all of the members are coming to terms with the suicide of one of their members.  Of course, she also takes pain medication and addiction is another of her problems...and of course there's more!

I guess I am writing this post just to bring readers' attention to the fact that Hollywood has become aware of the crisis that is chronic pain.  This movie is a testament to that. People that don't have to live with this kind of pain don't fully understand the whole story.  Maybe this movie will shed some light on the issues.

Here is the official trailer for the movie:


Sources: prweb;NorthJersey.com;YouTube


Herpes As A Helper?

If you've ever had shingles, or known anyone that has experienced it, you probably know that chronic pain can persist following the initial attack (post herpetic neuralgia).  This is because the herpes virus seems to have an affinity for nerve cells.  And while it's not fun to have shingles or post herpetic neuralgia, the herpes virus may be a key in future development of delivery systems for pain management treatments.





Here's the deal--since Herpes simplex has an affinity for nerve cells, researchers are looking a genetically modified, safer version of the virus to deliver genetic material to damaged nerves.  In simple terms, once the genetic material reaches these nerve cells, it will hopefully encode these nerves to ultimately inhibit pain signals.  Animal studies and clinical trials in cancer patients have been encouraging thus far.

This is one of those developments that makes me believe that there is hope for those in chronic pain. Along with so many other exciting d…

The Knee Bone's Connected To The Leg Bone....

Two recent studies have brought a not-so-novel concept into the limelight-the concept being that people who present with knee pain often develop pain in other parts of their bodies.  These studies, known as the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), were assessed by a Clinical Epidemiology Team as Boston University School of Medicine in an effort to find preventive strategies to combat this trend.




The authors suggest that knee pain may cause individuals to alter their gait in an effort to compensate for their discomfort. In doing so, the alignment of other body joints is altered, and this may be the cause of secondary joint pain, especially hips and ankles. The authors go on to say that the pain in these secondary sites is not necessarily osteoarthritis--perhaps bursitis or some other injury.

Osteoarthritis is a result of wear and tear in the joints.  We may not be able to completely eliminate osteoarthritis from occurring, but some common se…