Healthesystems clinicians reviewed evidence-based guidelines to assemble this reference for tapering and discontinuing opioid therapy.
Long-term opioid use often results in well-documented risks for the injured worker, payer and employer that include dependence, disability and high costs. In many cases, clinicians at a PBM can work with a prescriber to taper and discontinue opioid therapy and minimize or eliminate associated risks. There is limited evidence to support a specific rate of tapering or tapering protocol; however, best practices, recommendations and considerations were captured to create this resource.
To continue reading you must be logged in.
Please register for free or login to unlock the rest of this article.
RATE THIS ARTICLE
1 -Hegmann, K.T. & Glass, L.S. (Ed.) (2008) Occupational Medicine Practice Guidelines, 2nd Edition. American College of Occupational and Environmental Medicine (ACOEM)
2 -Washington State Department of Labor and Industries. Guideline for prescribing opioids to treat pain in injured workers. Olympia (WA): Washington State Department of Labor and Industries; 2013 Jul 1. 19 p
3 -Chou RT, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113-130.
4 -Department of Veterans Affairs, Department of Defense. (2010) The Management of Opioid Therapy for Chronic Pain Working Group, VA/DoD Clinical Practice Guideline, Management of Opioid Therapy for Chronic Pain. Washington, DC.
5 -Cowan DT, Wilson-Barnett J, Griffiths P, et al. A randomized, double-blind, placebo-controlled, cross-over pilot study to assess the effects of long-term opioid drug consumption and subsequent abstinence in chronic noncancer pain patients receiving controlled-release morphine. Pain Med. 2005;6(2):113-121.
6 -Hegmann, K.T. & Glass, L.S. (Ed.) (2008) Occupational Medicine Practice Guidelines, 2nd Edition. American College of Occupational and Environmental Medicine (ACOEM)
7 -Hegmann, K.T. & Glass, L.S. (Ed.) (2008) Occupational Medicine Practice Guidelines, 2nd Edition. American College of Occupational and Environmental Medicine (ACOEM)
8 -Clinical Centers of Excellence in Pain Management Awards Program. American Pain Society. http://www.americanpainsociety.org/about-aps/awards/clinical-centers-of-excellence-in-pain-management-awards.html. Accessed February 25, 2014.
9 -Washington State Pain Clinic Instills ‘Don’t Give Up’ Attitude. Pain Medicine News. 2013;11. http://www.painmedicinenews.com/ViewArticle.aspx?d=PRN&d_id=86&i=September+2013&i_id=991&a_id=2394. Accessed February 25, 2014.