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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


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