Pain Medicine News: HHS Announces Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use

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NOVEMBER 5, 2019

HHS Announces Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use

The Department of Health and Human Services (HHS) has published a new guide designed to help clinicians reduce or discontinue opioid use in their patients who are on long-term therapy.

The “Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics” can be found at https://www.hhs.gov/ opioids/ sites/ default/ files/ 2019-10/ Dosage_Reduction_Discontinuation.pdf.

“Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks,” the HHS wrote in a press release. This is complicated, however, by the fact that abruptly changing or discontinuing a prolonged opioid regimen can increase the risk for harm to the patient. The new guide provides advice to clinicians who are contemplating or initiating a change in opioid dosage, stressing the need for a thorough, deliberative case review and discussion with the patient.

“Care must be a patient-centered experience. We need to treat people with compassion, and emphasize personalized care tailored to the specific circumstances and unique needs of each patient,” Adm. Brett P. Giroir, MD, the assistant secretary for health at the HHS, said in a press release. “This guide provides more resources for clinicians to best help patients achieve the dual goals of effective pain management and reduction in the risk for addiction.”

The HHS stressed the clinician’s responsibility to coordinate patients’ pain treatment and opioid-related problems. In certain situations, according to the agency, a reduced opioid dosage may be indicated, in joint consultation with the care team and the patient.

“HHS does not recommend opioids be tapered rapidly or discontinued suddenly due to the significant risks of opioid withdrawal, unless there is a life-threatening issue confronting the individual patient,” according to the press release.

Compiled from published guidelines and practices endorsed in the peer-reviewed literature, the HHS’s guide covers important issues to consider when changing a patient’s chronic pain therapy. It lists issues to consider before making a change, including shared decision making with the patient; issues to consider when initiating the change; and issues to consider as a patient’s medication dosage is being tapered, including the need to treat symptoms of opioid withdrawal and provide behavioral health support.

Based on a press release from the HHS.

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