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Opioid Tapering Schedule Now Available for Practitioners

The opioid epidemic, now considered a national emergency, touches all corners of our society. At a recent internal medicine conference in Estes Park Colorado, Sunny Linnebur, PharmD discussed how physicians will be increasingly required by state agencies to taper opioid use among patients with chronic pain. Linnebur, professor of clinical pharmacy at the University of Colorado, Aurora, told conference attendees that an opioid tapering schedule is the ideal solution.

Linnebur suggests using an interactive guide (attached below), developed by Washington State Sunny LinneburHealth Care Authority for these situations. ““If you type in a patient’s opioid medication and dose, it will give you a week-to-week calendar schedule for tapering,” she explained at the conference. “We know that getting patients on the safest dose of opioid is important, but it’s also difficult. This is an objective taper schedule that will prevent the patient from withdrawing from their opioid and hopefully will help in tolerating the reduction.”

DOWNLOAD THE TAPERING SCHEDULE TOOL HERE.

The Centers for Disease Control recommend the following when tapering a patient away from opioid use:

1. A decrease of 10% of the original dose per week is a reasonable starting point.

2. Adjust the rate and duration of the taper according to the patient’s response.Some patients who have taken opioids for a long time might find even slower tapers (e.g., 10% per month) easier.

Don’t reverse the taper; however, the rate may be slowed or paused while monitoring and managing withdrawal symptoms.
3. Once the smallest available dose is reached, the interval between doses can be extended and opioids may be stopped when taken less than once a day.
4. Coordinate with specialists and treatment experts as needed—especially for patients at high risk of harm such as pregnant women or patients with an opioid use disorder.
5. Make sure patients receive appropriate psychosocial support. If needed, work with mental health providers, arrange for treatment of opioid use disorder, and offer naloxone for overdose prevention.
6. Let patients know that most people have improved function without worse pain after tapering opioids. Some patients even have improved pain after a taper, even though pain might briefly get worse at first.

CLICK HERE FOR THE CDC POCKET GUIDE: TAPERING OPIOIDS FOR CHRONIC PAIN

DOWNLOAD THE OPIOID TAPERING TOOL HERE

 

 

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