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?
- See the ADHS guidelines section addressing exit strategies (PDF).
- Note: Tapering treatment is not the only option and may not be appropriate for every patient.