Just as starting and maintaining opioid therapy should be done with caution and only under the supervision of a trained professional, so should the discontinuation of opioid therapy. Always consult with your doctor so together you can develop a plan to safely and effectively discontinue opioids.
There are several reasons to discontinue chronic opioid therapy for a patient who has been receiving opioids for management of a chronic pain conditions. These include medication side effects, patient’s wish to discontinue opioid therapy, loss of meaningful clinical benefit from the medications, misuse or concerns regarding adherence to the treatment agreement and office policies, reduction in one’s pain no longer requiring opioid therapy, and as well as changes in one’s health resulting in opioid therapy being more harmful than beneficial.
Opioid rotation is an alternative to discontinuation; however, patients may be wary to try another agent or may experience intolerable adverse effects with certain chemical classes of opioids. Often, implementing an “exit” strategy will involve tapering the opioid that you are taking.
Weaning from opioids can be done safely by slowly tapering the opioid dose and considering several other factors. As each individual is different, your doctor will tailor a tapering plan based on your needs. An accepted rule of thumb for the safe and slow tapper of opioid therapy is reduction of your current dose by 10% each week.
Keep in mind that some patients can be tapered more rapidly without problems. Opioid withdrawal syndrome may occur and is unpleasant, but it is typically not medically serious. Please note that although withdrawal from opioids is not considered lethal, significant withdrawal from benzodiazepines and alcohol can be deadly. Significant withdrawal is also possible with Soma®, so titrating off slowly is critical to those discontinuing this medication.