Weaning down opioids in the inherited patients on high-dose opioids
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* Alaa Abd-Elsayed
* Eric S Schwenk

*   analgesics
*   opioid
*   chronic pain
*   analgesia

## Abstract

Patients who receive high-dose opioid therapy for chronic non-cancer pain (CNCP) are at risk for opioid dependence, misuse, and overdose death. Transitions of care between physicians complicate the situation. This retrospective study described the opioid tapering experience of one outpatient pain practice that performed a slow wean over 12 months in patients maintained at least 120 mg of daily oral morphine equivalents for at least 6 months. The authors assessed compliance through patient history, state online prescription monitoring program, and frequent random urine toxicology screening. They reported that 57 of 91 patients who were evaluated (63%) achieved the meaningful reduction criterion at 12 months after the transition of care. The average reduction of daily oral morphine equivalents was 210 mg vs 127 mg in the groups that did and did not achieve meaningful reductions, respectively. The authors concluded that a slow taper in the ambulatory setting of patients with CNCP taking high-dose opioids can be successful in a substantial proportion of patients.

![Figure1](http://rapm.bmj.com/https://rapm.bmj.com/content/rapm/46/6/537/F1.medium.gif)

[Figure1](http://rapm.bmj.com/content/46/6/537/F1)

## Ethics statements

### Patient consent for publication

Not required.

## Footnotes

*   Correction notice This article has been corrected since it published Online First. The second author's name has been corrected and the provenance and peer review statement has been included

*   Contributors All authors contributed to the design and writing of this work.

*   Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

*   Competing interests None declared.

*   Provenance and peer review Commissioned; internally peer reviewed.

*   Received December 10, 2020.
*   Revision received December 17, 2020.
*   Accepted December 20, 2020.


*   © American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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