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The challenge: to reduce the dose without an increase in patient-reported pain intensity.
Addressing the risks associated with long-term moderate- to very high-dose opioid therapy has become a national priority. Research presented at the American Academy of Pain Medicine 34th Annual Meeting in Vancouver, BC, finds that individualized, patient-centered opioid tapering programs are successful in reducing opioid doses without increasing patient-reported pain intensity or pain interference.
The study followed nearly 100 outpatients with chronic pain who were receiving long-term opioid therapy. These outpatients were provided education about the benefits of reducing opioids by their prescribing physician, who then partnered with them to create and implement an individually tailored opioid taper program.
At 4-month follow-up, the patients-on average-exceeded a 50% opioid dose reduction. Furthermore, the results of the study suggest that some patients are interested in reducing their prescription opioid doses; however, those who receive long-term opioid therapy may require a tapering program that lasts 4 months or longer to achieve opioid cessation.
“Our research highlights the need for individualized tapering programs that meet the patients’ specific needs,” says lead author, Maisa Ziadni, PhD. “Aggressive taper schedules lead to patient discomfort and distress, taper failure, and false beliefs that successful tapering is impossible and opioids must be continued. Our data suggest that tapering to lower and safer opioid doses is possible.”
Ziadni M, Stieg R, Mackey I, et al. Patient-centered prescription opioid tapering in community outpatients with chronic pain. Presented at: American Academy of Pain Medicine 34th Annual Meeting; April 25-29, 2018; Vancouver, BC, Canada. Abstract 190.
Individualized approach to opioid tapering shows success in chronic pain patients using long-term opioids [press release]. Chicago, IL: American Academy of Pain Medicine; April 26, 2018.