The Department of Health and Human Services has released a decision-making guide for physicians who are considering reducing or discontinuing opioid treatment for their patients. The 5-page booklet discusses:

• The situations in which opioid tapering or discontinuation may be appropriate
• The risks of rapid opioid tapering
• Steps to take before dose reduction
• Symptoms of opioid withdrawal
• The importance of mental health support
• Evaluation for opioid use disorder, and special considerations for treatment

“In each case the clinician should review the risks and benefits of the current therapy with the patient, and decide if tapering is appropriate based on individual circumstances,” the authors state. “Opioids should not be tapered rapidly or discontinued suddenly due to the risks of significant opioid withdrawal … Clinicians have a responsibility to provide or arrange for coordinated management of patients’ pain and opioid-related problems, and they should never abandon patients.” ¹

The booklet is available at HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics.

¹ D Dowell, C Jones, W Compton, co-Chairs. HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. 2019: US Department of Health and Human Services