Opioid tapering

Opioid tapering is the reduction of opioid doses over time. Opioid tapering is typically done in people taking opioids for chronic pain. Tapering may be conducted in medically-supervised inpatient or outpatient settings.

Community-based opioid tapering increased after the 2016 “Center for Disease Control Guideline for Prescribing Opioids in Chronic Pain” was published, and many prescribers and organizations instigated opioid tapering practices in order to reduce opioid prescribing.[1]

Voluntary patient-centered opioid tapering has shown success with engagement and reduction of moderate and high-dose opioid doses over the course of months.[2] Principles of patient-centered opioid tapering include: patient consent to taper, patient ability to control the pace of the taper, and pause the taper if desired.

Some healthcare providers have expressed concern about negative consequences of rapid forced tapering including suicidality.[3] Human Rights Watch has called forced opioid tapering in those with chronic pain to be a “human rights issue."[4]

In April 2019, the Federal Drug Administration issued a drug safety communication warning against sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering.[5]