Moving On From Opioids: Tapering and Cessation

We just want to remind clinicians that it's an interdisciplinary approach that's going to help people the most, especially when you're weaning people off of medications. If the opiates have been the primary tool that they've used to manage their pain and you're taking that away, you need to give them other tools, not necessarily other drugs but other non-pharmacologic treatment modalities. One of the biggest challenges to tapering is fear. Patients become very reliant on the medications. They become dependent. Dependence isn't the same thing as addiction. When people are very psychologically dependent, it's challenging to get them to accept that there can be another possibility of managing their pain. In our inpatient program, we wean them using a dosage blinded pain cocktail, so they're not aware of how fast the changes are occurring and they're concurrently working with physical therapy, occupational therapy and psychology to help them develop other tools to manage their pain. When you're inheriting a new patient, it's a great opportunity for education. The patient has learned one certain way of how to manage their pain with the clinician that they've worked with before. Now you have a wonderful opportunity to re-educate the patient on different ways of managing pain.