How should I taper my patient off of opioids?

  • There are many different factors that should go into the decision on how to execute an opioid taper, if appropriate.
  • While the Arizona Department of Health Services' (ADHS) chronic pain guidelines recommend slower tapers, such as reducing morphine equivalent doses (MEDs) by 5-20 percent every four weeks with pauses in taper as needed and appropriate follow-up, there are slower and faster taper strategies that could be beneficial.
  • Considerations for tapering along with example tapers, follow-up schedules, and adjunct medication for withdrawal symptoms can be found in the exit strategy section of the ADHS chronic pain guidelines (PDF).
  • The VA guidelines also have a flow sheet algorithm for tapering opioids (PDF).

My patient and I have agreed to taper the opioid use. How should I go about this?