A study recently published in JAMA looked at solutions for patients and physicians to successfully reduce long-term prescription opioid dosages in settings without behavioral services. The risks associated with prescription opioids are well described. Although reducing opioid use is a national priority, existing opioid tapering models use costly interdisciplinary teams that are largely inaccessible to patients and their physicians.
This study of voluntary, patient-centered opioid tapering in outpatients with chronic pain without behavioral treatment suggests that a substantial fraction of patients at a pain clinic may wish to engage in voluntary opioid tapering. The data collected challenged common notions that patients taking high-dose opioids will fail outpatient opioid tapers or that duration of opioid use predicts taper success. Combining patient education about the benefits of opioid reduction with a plan that reduces opioids more slowly than current tapering algorithms with close clinician follow-up, may help patients engage and succeed in voluntary outpatient tapering. Because the data in this study was generated from a single pain clinic, additional studies are needed to assess how well our protocol would generalize to other types of patients and settings.