Evidence Brief: Benefits and Harms of Long-term Opioid Dose Reduction or Discontinuation in Patients with Chronic Pain

A systematic review of the evidence for long term outcomes of tapering opioid doses in patients on long term opioid therapy for chronic pain from the Veterans Affairs Evidence Synthesis Program (ESP). The report analyzes published studies to determine the benefits and harms for patients when tapering their opioid medications to lower doses or discontinuation and reviews whether benefits and harms vary by patient co-morbidities, the indication for tapering, patient engagement in the tapering process, baseline opioid dose and medication regimen, and the tapering protocol used. The review places a special foci on the need to avoid untended harms to patients undergoing tapering and the effects of tapering on the veteran population.

Authors: add authors: R. Smart, C. Kase, A. Meyer, B. Stein

Funding Source: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services