Module 4: Therapeutics
The Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain provides guidance for opioid tapering (NOUGG, 2017).
Tapering opioids is often necessary when dependence has occurred and pain relief/functional goals are not being met despite trials of several different opioids. It can also be necessary when long-term and higher doses result in suspected hyperalgesia or pain sensitization.
Opioids should always be tapered carefully and thoughtfully and not simply discontinued. Patients should be followed closely throughout the process.