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Tapering To Lower Dose of Opioids

According to a study, "Of 82 patients, 31 did not complete the 4-month survey and were considered to have dropped out of the study. Depression negatively correlated (P=0.05) and baseline marijuana use positively correlated (P=0.04) with completing the study.

To confirm results of the 51 patients who finished the study, researchers reviewed medical records, periodic urine tests, and the state Prescription Drug Monitoring Program (PDMP), and found no aberrations in compliance or prescriptions.

At baseline, the median daily MME of study completers was 288 mg and they had a median of 6 years of opioid use. Pain intensity was 5 out of 10 on a numeric pain rating.

After 4 months, the median daily MME dropped to 150 mg (P=0.002). Pain intensity (P=0.29) and pain interference (P=0.44) did not increase.

This research shows dose and duration may not be as important as we think.

"Common lore is that patients taking high dose opioids are unlikely to have successful outpatient opioid taper results -- or if they have been taking opioids for years or even decades they will likely have a poor taper response," she said. "To the contrary, we found that starting dose and duration of use did not predict taper response."

It also "helps debunk the idea that patients have to stay on dangerously high doses," said Andrew Kolodny, MD, of Brandeis University in New York and a prominent opponent of opioids for chronic noncancer pain. "It shows that with support and patience, people can come down to safer levels."

"But what's unaddressed is that the majority of these individuals would probably be better off if they could come completely off opioids," he told MedPage Today.

If a self taper protocol is not successful for you or you would like to completely stop taking opiates, a medical detox could be the best option for you.

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