opioid tapering

opioid tapering

You’ve had enough. You spent the past several years trying and failing to address your opioid use disorder. When you quit, the withdrawals were so strong that you found yourself seeking out opioids once more to counteract them. It’s a vicious cycle that you’re ready to change.

Maybe that’s not you, and instead, you were prescribed an opioid after a serious accident or for chronic pain. It can be difficult to get off opioids in your case, too. Either way, how do you safely and effectively put an end to opioid use? For the past several years, opioids have been prescribed about 45% more in Appalachian counties than anywhere else in the United States, so this is a concern for many in our communities.

For some, opioid tapering (or “weaning off”) may seem like a viable option for putting opioids behind them. ReVIDA® Recovery is well-versed in this method, and it isn’t always the safest choice. We are a facility that is medically qualified to perform medication-assisted treatment (MAT), which assists many patients in overcoming opioid use disorders. More than that, we understand the challenges of recovery, and always welcome patients, whether it is their first time with us, or they’ve been with us before and require additional help.

What exactly is opioid tapering, though, and how does it work? We’ll delve into that in this article.

What Is Opioid Tapering?

Opioid tapering is the gradual reduction of opioids in the body. Patients must go through the tapering process with a physician and not alone. It is a precise process, and can even be dangerous when not carried out properly. The exact way to carry out opioid tapering also depends on each individual, so medical expertise is vital in guiding the process.

Different Methods of Opioid Tapering

There are two primary methods of tapering: fast (also known as rapid) tapering and slow tapering. Each is meant to help the patient stop taking the opioid altogether in a safe manner.

Slow tapering is the most commonly recommended method, especially for patients who have been on opioids long-term (over six months). This process consists of lowering the dose of the opioid by 10% to 25% every week to a month, and once the patient achieves the lowest dose, reducing days of taking it until they aren’t taking the opioid anymore at all.

Fast tapering is typically only recommended for those who have been on opioids for less than six months. Fast tapering consists of reducing the opioid dose by 10% to 25% over a few days to a week. Going any faster than this can cause severe withdrawal symptoms, and close monitoring by a physician is required.

opioid tapering process steps

Why Bring Up Opioid Tapering With Your Doctor?

Opioid tapering is a safe and effective way to slowly remove opioids from the body, but only when done under a physician’s care. Anyone looking to stop opioid use should consider tapering because it reduces the potential for painful withdrawals. This is true for any patient using opioids, whether they were prescribed it for medical reasons or are using opioids illicitly.

In most medical cases, the practitioner will not prescribe the opioids in the first place without a plan for stopping them, with tapering being the most common option. Opioids are often strong medications with the ability to cause dependency in those taking them, so it isn’t ideal to stay on them for a long time.

When It’s Time to Stop Using Opioids

For those using opioids illicitly, there is never a bad time to seek help. For those prescribed opioids by a doctor, however, it can be more difficult to know when it’s time to cut back on their dose or try to get off of the medication altogether.

When a doctor is considering whether to lower opioid dosage or not, they will consider whether there has been a significant enough improvement in pain. If the patient is on a high dose of an opioid, but their pain is still present or worse than before, that is a sign it may be time to lower the dose or help the patient stop taking opioids altogether. The doctor will also consider whether the person taking the opioid is also taking benzodiazepines, as taking both medications simultaneously significantly increases the risk of overdose. Additionally, the doctor will look for signs of an opioid use disorder, including but not limited to:

  • Taking the opioid in larger doses for a longer period than intended
  • Using opioids consistently despite significant adverse effects
  • Obtaining and taking opioids significantly impacts the patient’s life

If you are a person taking opioids and wondering if it’s time to stop, you should ask yourself the same questions mentioned above. Think seriously about your pain levels, and how long you have been on your medication. Taking opioids long-term can not only cause stronger withdrawal symptoms when you try to stop them but also cause painful side effects. You should also consider exactly why you are taking opioids, especially if you’ve been on them for more than a month. If it’s for anything other than pain, such as to relax or feel less anxious, you are in dangerous territory and should talk to a doctor about tapering off your medication as soon as possible.

Ultimately, you can discuss your opioid use with a doctor at any time. Every situation is different, and counsel with a medical professional should be instrumental in your decision and process in quitting opioid use.

Opioid Tapering vs. Cold Turkey

“Cold turkey” is likely a far more familiar phrase than “opioid tapering,” but it isn’t the recommended method of stopping opioid use. Quitting any medication “cold turkey” means stopping it altogether, immediately, without gradually lowering the dose.

Quitting cold turkey may seem appealing because tapering can take a long time. It is tempting to simply stop using the opioid to “get it over with,” but opioid use can cause withdrawal symptoms even after a few days, and quitting cold turkey greatly increases the risk of experiencing them. The severity of withdrawal symptoms increases based on how long the patient has taken the opioid. Long-term use will create a larger likelihood for withdrawal symptoms, and make those symptoms more severe. In some cases, someone experiencing opioid withdrawal may take a larger dose of the opioid than they were before to try and quickly combat withdrawal symptoms. This increases the chance of an opioid overdose.

Tapering does not guarantee a lack of withdrawal symptoms, but it is a safer and less painful way of stopping opioids, so long as you are under medical supervision.

How Opioid Tapering Helps

Opioid tapering can seem daunting. Patients may worry their pain will increase without opioids in their lives, but there is evidence that tapering opioids may not impact the pain levels the patient feels at all, and may sometimes decrease pain.

Tapering can also help patients experience less severe withdrawal symptoms when quitting opioids, whether they have been on them long-term or for a shorter period of time. Tapering without a doctor’s help is dangerous, though. Patients will not know the exact dosage they are required to take, and just looking up how to taper online isn’t a substitution for medical expertise. There is not a “one size fits all” approach to tapering, and there is no way for patients to build a sufficient plan for removing opioids from their lives alone.

Tips to Help You Through Opioid Tapering

While opioid tapering is a helpful and often necessary process, that doesn’t mean it’s an easy one. Fast tapering may cause severe withdrawal symptoms, and even slow tapering can have unwanted effects.

Doctors know what to do to make this process as painless as possible. The most common way of tapering is to lower the dosage of the opioid, and then the frequency afterward. For example, a patient taking two doses of opioids three times a day (so six doses total) will likely start tapering by going down to five doses per day. They would, for example, take two doses in the morning, one dose in the middle of the day, and two doses at night. After a few days, they would go down to one dose in the morning, one in the middle of the day, and two at night. When the patient is down to one dose three times per day, then the plan will be to lower the frequency they take the opioid. Maintaining a steady flow of medication in the body, even at a lower dosage, will help reduce withdrawal symptoms. If, instead of lowering the dosage of the medication first, frequency was reduced first, it could cause withdrawals.

This article is not a substitute for medical help, so doctors and patients must communicate at all times during the patient’s tapering process. Doctors will have better, more customized advice for individual patients with tapering difficulties. However, there are some things patients can do at home to help themselves with the tapering process, including:

  • Staying hydrated
  • Avoiding alcohol and other substances while tapering
  • Seeking support from friends and family
  • Fitting relaxation time into their day
  • Getting light exercise
  • Eating well-balanced meals

reducing opioid use

Find Help With Opioid Addiction at ReVida® Recovery

While tapering can be a hard process for anyone, it presents an additional difficulty for those with an opioid use disorder. These people have likely been on opioids for a long time and may have trouble imagining their life without them.

If that sounds like you, recovery is possible, and your treatment plan will most likely include tapering.

At ReVIDA® Recovery, we are well qualified to help you overcome your opioid use disorder. With several locations throughout Tennessee and Virginia, our care is accessible to many in the Appalachian region. We also know that living life in recovery isn’t easy, and provide support for our patients outside of treatment in areas such as job seeking, housing, food insecurity, and more. Ready to reclaim your life from opioid use? Give us a call at 423-631-0432 today.

How Long Does Suboxone® Block Opiates

FAQ

What is the tapering process? 

Tapering is the process of “weaning” someone off of a medication, often used to help patients stop taking opioids. Tapering can consist of fast tapering or slow tapering. The fast tapering process involves reducing opioids by 10% to 25% over a few days. Slow tapering reduces opioids in the system over a far longer period, making withdrawal symptoms less likely.

What does it mean to be weaned from opioids?

Weaning off of a medication is the process of slowly reducing the dosage of medication until you can safely get off of it altogether. This process reduces the potential for withdrawal symptoms and side effects and is also known as tapering.

What is the medical term for tapering off medication? 

There is no additional medical term for tapering. While the general population often speaks of “weaning” off of a medication, “tapering” is the term most used in the medical community.