Key Questions: How can I set up an opioid tapering plan for my patients? What strategies can my organization use to taper safely?
This tapering toolkit is designed to assist providers to engage their patients on high dose opioids in a stepwise physician-directed tapering process and to provide guidance on the management of complications and special scenarios during the tapering process. The four steps described in this toolkit are to identify candidates for tapering, set a tapering plan in collaborative consultation with the patient, manage the tapering process and complications, plan for special situations and contingencies.
Tapering the dose of opioids in high-risk patients can reduce the above risks with lower mortality and higher quality of life. Recent guidelines issued by the Centers for Disease Control and Prevention emphasize that the above risks, especially overdose, and death, increase dramatically with opioid doses over 50 morphine equivalents (MED), and opioids should be used with extreme caution over 90 MED.