Advanced search
Publication Cover
Substance Abuse Volume 39, 2018 - Issue 2: Implementation and Quality Improvement: Applying and Advancing Best Practices in Opioid Use Disorder and Addiction Treatment
Journal homepage
1,324
Views
47
CrossRef citations to date
0
Altmetric
Commentaries

The conundrum of opioid tapering in long-term opioid therapy for chronic pain: A commentary

Ajay Manhapra MDVA New England Mental Illness Research and Education Center, West Haven, Connecticut, USA;Advanced Pact Pain Clinic, VA Hampton Medical Center, Hampton, Virginia, USA;Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USACorrespondence[email protected]
,
Albert J. Arias MDVA New England Mental Illness Research and Education Center, West Haven, Connecticut, USA;Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
&
Jane C. Ballantyne MDDepartment of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Pages 152-161 | Published online: 18 Oct 2017

Citations (47)

Keep up to date with the latest research on this topic with citation updates for this article.

Subscribe to citation updates

Read on this site (4)

Phillip O. Coffin, Rebecca S. Martinez, Brian Wylie & Bunny Ryder. (2022) Primary care management of Long-Term opioid therapy. Annals of Medicine 54:1, pages 2450-2468.
Read now
Lee A. Kral, Jeffrey J. Bettinger, Christine M. Vartan, Katherine Hadlandsmyth, Justin Kullgren & Michael A. Smith. (2022) A Survey on Opioid Tapering Practices, Policies, and Perspectives by Pain and Palliative Care Pharmacists. Journal of Pain & Palliative Care Pharmacotherapy 36:1, pages 2-10.
Read now
Adam J. Gordon$suffix/text()$suffix/text() & Elizabeth M. Oliva$suffix/text()$suffix/text(). (2018) Applying and advancing best practices in opioid use disorder and addiction treatment: Introduction to the special issue on implementation science and quality improvement scholarship. Substance Abuse 39:2, pages 125-128.
Read now
Hance Clarke, Saam Azargive, Janice Montbriand, Judith Nicholls, Ainsley Sutherland, Liliya Valeeva, Sherif Boulis, Kayla McMillan, Salima S. J. Ladak, Karim Ladha, Rita Katznelson, Karen McRae, Diana Tamir, Sheldon Lyn, Alexander Huang, Aliza Weinrib & Joel Katz. (2018) Opioid weaning and pain management in postsurgical patients at the Toronto General Hospital Transitional Pain Service. Canadian Journal of Pain 2:1, pages 236-247.
Read now

Articles from other publishers (43)

Bobbi Jo H. Yarborough, Scott P. Stumbo, Jennifer L. Schneider, Brian K. Ahmedani, Yihe G. Daida, Stephanie A. Hooker, Sonya Negriff, Rebecca C. Rossom & Gwen Lapham. (2023) Impact of Opioid Dose Reductions on Patient-Reported Mental Health and Suicide-Related Behavior and Relationship to Patient Choice in Tapering Decisions. The Journal of Pain.
Crossref
Mark OlfsonTimothy WaidmannMarissa KingVincent PanciniMichael Schoenbaum. (2023) Opioid Prescribing and Suicide Risk in the United States. American Journal of Psychiatry 180:6, pages 418-425.
Crossref
Lara Michal Skarf, Katie Fitzgerald Jones, Jordana L. Meyerson & Janet L. Abrahm. (2023) Pharmacologic Pain Management: What Radiation Oncologists Should Know. Seminars in Radiation Oncology 33:2, pages 93-103.
Crossref
Matthew D Turner. (2023) “A Profound, Abiding Hatred”: An Analysis of Hermann Goering’s Alleged Morphine Addiction. Cureus.
Crossref
Victoria D. Powell, Colin Macleod, Jeremy Sussman, Lewei A. Lin, Amy S. B. Bohnert & Pooja Lagisetty. (2022) Variation in Clinical Characteristics and Longitudinal Outcomes in Individuals with Opioid Use Disorder Diagnosis Codes. Journal of General Internal Medicine 38:3, pages 699-706.
Crossref
Katie Fitzgerald Jones Jessica S. merlin & Julie W. Childers. 2023. Evidence-Based Practice of Palliative Medicine. Evidence-Based Practice of Palliative Medicine 85 93 .
Deborah Dowell, Kathleen R. Ragan, Christopher M. Jones, Grant T. Baldwin & Roger Chou. (2022) CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022 . MMWR. Recommendations and Reports 71:3, pages 1-95.
Crossref
Orrin D. Ware, Jennifer D. Ellis, Kelly E. Dunn, J. Gregory Hobelmann, Patrick Finan & Andrew S. Huhn. (2022) The association of chronic pain and opioid withdrawal in men and women with opioid use disorder. Drug and Alcohol Dependence 240, pages 109631.
Crossref
Deborah S. HasinDvora ShmulewitzMalka StohlEliana GreensteinEfrat AharonovichKenneth R. PetronisMichael Von KorffSamyadev DattaNomita SontyStephen RossCharles InturrisiMichael L. WeinbergerJennifer ScodesMelanie M. Wall. (2022) Diagnosing Prescription Opioid Use Disorder in Patients Using Prescribed Opioids for Chronic Pain. American Journal of Psychiatry 179:10, pages 715-725.
Crossref
Kellene Eagen, Laurel Rabson & Rebecca Kellum. (2022) Management of Chronic Pain in Patients with Substance Use Disorders. Primary Care: Clinics in Office Practice 49:3, pages 455-468.
Crossref
Jeffrey F. Scherrer, Joanne Salas, Lisa R. Miller-Matero, Mark D. Sullivan, Jane C. Ballantyne, Lynn Debar, Richard A. Grucza, Patrick J. Lustman & Brian Ahmedani. (2022) Long-term prescription opioid users' risk for new-onset depression increases with frequency of use. Pain 163:8, pages 1581-1589.
Crossref
Ajay Manhapra. (2022) Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome. Current Treatment Options in Oncology 23:7, pages 921-935.
Crossref
Sara N. Edmond, Jennifer L. Snow, Jamie Pomeranz, Raymond Van Cleve & William C. Becker. (2022) Arguments for and Against a New Diagnostic Entity for Patients With Chronic Pain on Long-Term Opioid Therapy for Whom Harms Outweigh Benefits. The Journal of Pain 23:6, pages 958-966.
Crossref
Katie Fitzgerald Jones & Jessica S. Merlin. (2021) Approaches to opioid prescribing in cancer survivors: Lessons learned from the general literature. Cancer 128:3, pages 449-455.
Crossref
Lori Schirle, Alvin Jeffery, Ali Yaqoob, Sandra Sanchez-Roige & David C. Samuels. (2021) Two data-driven approaches to identifying the spectrum of problematic opioid use: A pilot study within a chronic pain cohort. International Journal of Medical Informatics 156, pages 104621.
Crossref
Paige D. Wartko, Denise M. Boudreau, Judith A. Turner, Andrea J. Cook, Robert D. Wellman, Monica M. Fujii, Robin C. Garcia, Kathryn A. Moser & Mark D. Sullivan. (2021) STRategies to Improve Pain and Enjoy life (STRIPE): Protocol for a pragmatic randomized trial of pain coping skills training and opioid medication taper guidance for patients on long-term opioid therapy. Contemporary Clinical Trials 110, pages 106499.
Crossref
Christine Timko, Kurt Kroenke, Andrea Nevedal, Mai Chee Lor, Elizabeth Oliva, Karen Drexler, Friedhelm Sandbrink & Katherine Hoggatt. (2021) Development and field testing of primary care screening tools for harms of long-term opioid therapy continuation and tapering to discontinuation: a study protocol. BMJ Open 11:10, pages e053524.
Crossref
George ComerciJrJr, Lisa Marr & Esme Finlay. (2020) End Stage Chronic Pain (ESCP): Naming Complex Suffering in the Opioid Crisis Era. American Journal of Hospice and Palliative Medicine® 38:9, pages 1078-1082.
Crossref
Victoria D. Powell, Jack M. Rosenberg, Avani Yaganti, Claire Garpestad, Pooja Lagisetty, Carol Shannon & Maria J. Silveira. (2021) Evaluation of Buprenorphine Rotation in Patients Receiving Long-term Opioids for Chronic Pain. JAMA Network Open 4:9, pages e2124152.
Crossref
Alicia Agnoli, Guibo Xing, Daniel J. Tancredi, Elizabeth Magnan, Anthony Jerant & Joshua J. Fenton. (2021) Association of Dose Tapering With Overdose or Mental Health Crisis Among Patients Prescribed Long-term Opioids. JAMA 326:5, pages 411.
Crossref
John Bailey, Sadia Nafees, Lucy Jones & Rob Poole. (2020) Rationalisation of long-term high-dose opioids for chronic pain: development of an intervention and conceptual framework. British Journal of Pain 15:3, pages 326-334.
Crossref
Jane Quinlan, Heather Willson & Katheryn Grange. (2020) Hopes and fears before opioid tapering: a quantitative and qualitative study of patients with chronic pain and long-term opioids. British Journal of Pain 15:2, pages 120-128.
Crossref
Wesley Jones, Scott Junkins & Drew A. Rosielle. (2021) Tapering Opioids in Patients with Serious Illness: How to Taper #414. Journal of Palliative Medicine 24:5, pages 784-785.
Crossref
Benjamin A. Howell, Erica A. Abel, Dongchan Park, Sara N. Edmond, Leah J. Leisch & William C. Becker. (2020) Validity of Incident Opioid Use Disorder (OUD) Diagnoses in Administrative Data: a Chart Verification Study. Journal of General Internal Medicine 36:5, pages 1264-1270.
Crossref
Pooja Lagisetty, Claire Garpestad, Angela Larkin, Colin Macleod, Derek Antoku, Stephanie Slat, Jennifer Thomas, Victoria Powell, Amy S.B. Bohnert & Lewei A. Lin. (2021) Identifying individuals with opioid use disorder: Validity of International Classification of Diseases diagnostic codes for opioid use, dependence and abuse. Drug and Alcohol Dependence 221, pages 108583.
Crossref
Dokyoung S. You, Aram S. Mardian, Beth D. Darnall, Chwen-Yuen A. Chen, Korina De Bruyne, Pamela D. Flood, Ming-Chih Kao, Anita D. Karnik, Jennifer McNeely, Joel G. Porter, Robert P. Schwartz, Richard L. Stieg & Sean C. Mackey. (2021) A Brief Screening Tool for Opioid Use Disorder: EMPOWER Study Expert Consensus Protocol. Frontiers in Medicine 8.
Crossref
Jeffrey F. Scherrer, Joanne Salas, Richard Grucza, Mark D. Sullivan, Patrick J. Lustman, Laurel A. Copeland & Jane C. Ballantyne. (2021) Depression and Buprenorphine Treatment in Patients with Non-cancer Pain and Prescription Opioid Dependence without Comorbid Substance Use Disorders. Journal of Affective Disorders 278, pages 563-569.
Crossref
Daniel L. Krashin, Natalia Murinova & Jane Ballantyne. 2021. Textbook of Addiction Treatment. Textbook of Addiction Treatment 535 546 .
Amy A. Case, Michelle Walter, Megan Pailler, LuAnn Stevens & Eric Hansen. (2020) A Practical Approach to Nonmedical Opioid Use in Palliative Care Patients With Cancer: Using the PARTNERS Framework. Journal of Pain and Symptom Management 60:6, pages 1253-1259.
Crossref
William C. Becker, Erin E. Krebs, Sara N. Edmond, Lewei A. Lin, Mark D. Sullivan, Roger D. Weiss & Adam J. Gordon. (2020) A Research Agenda for Advancing Strategies to Improve Opioid Safety: Findings from a VHA State of the Art Conference. Journal of General Internal Medicine 35:S3, pages 978-982.
Crossref
Evelyn T. Chang, Rebecca S. Oberman, Amy N. Cohen, Stephanie L. Taylor, Elisa Gumm, Aram S. Mardian, Shawn Toy, Araceli Revote, Britney Lewkowitz & Elizabeth M. Yano. (2020) Increasing Access to Medications for Opioid Use Disorder and Complementary and Integrative Health Services in Primary Care. Journal of General Internal Medicine 35:S3, pages 918-926.
Crossref
Stefan G. Kertesz, Megan B. McCullough, Beth D. Darnall & Allyson L. Varley. (2020) Promoting Patient-Centeredness in Opioid Deprescribing: a Blueprint for De-implementation Science. Journal of General Internal Medicine 35:S3, pages 972-977.
Crossref
Ajay Manhapra, Mark D. Sullivan, Jane C. Ballantyne, R. Ross MacLean & William C. Becker. (2020) Complex Persistent Opioid Dependence with Long-term Opioids: a Gray Area That Needs Definition, Better Understanding, Treatment Guidance, and Policy Changes. Journal of General Internal Medicine 35:S3, pages 964-971.
Crossref
Laura G. Militello, Robert W. Hurley, Robert L. Cook, Elizabeth C. Danielson, Julie Diiulio, Sarah M. Downs, Shilo Anders & Christopher A. Harle. (2020) Primary Care Clinicians’ Beliefs and Strategies for Managing Chronic Pain in an Era of a National Opioid Epidemic. Journal of General Internal Medicine 35:12, pages 3542-3548.
Crossref
Edward C. Covington, Charles E. Argoff, Jane C. Ballantyne, Penney Cowan, Halena M. Gazelka, W. Michael Hooten, Stefan G. Kertesz, Ajay Manhapra, Jennifer L. Murphy, Steven P. StanosJr.Jr. & Mark D. Sullivan. (2020) Ensuring Patient Protections When Tapering Opioids: Consensus Panel Recommendations. Mayo Clinic Proceedings 95:10, pages 2155-2171.
Crossref
Gregory D. Rudolf. (2020) Buprenorphine in the Treatment of Chronic Pain. Physical Medicine and Rehabilitation Clinics of North America 31:2, pages 195-204.
Crossref
Emily Behar, Rita Bagnulo, Kelly Knight, Glenn-Milo Santos & Phillip O. Coffin. (2020) “Chasing the pain relief, not the high”: Experiences managing pain after opioid reductions among patients with HIV and a history of substance use. PLOS ONE 15:3, pages e0230408.
Crossref
Joseph V. Pergolizzi, Giustino Varrassi, Antonella Paladini & JoAnn LeQuang. (2019) Stopping or Decreasing Opioid Therapy in Patients on Chronic Opioid Therapy. Pain and Therapy 8:2, pages 163-176.
Crossref
Alexander C. Tsai, Mathew V. Kiang, Michael L. Barnett, Leo Beletsky, Katherine M. Keyes, Emma E. McGinty, Laramie R. Smith, Steffanie A. Strathdee, Sarah E. Wakeman & Atheendar S. Venkataramani. (2019) Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLOS Medicine 16:11, pages e1002969.
Crossref
N. Cantagrel, C. Lestrade & A. Roussin. (2019) Différence de perception de l’attachement aux antalgiques entre le médecin et le patient. Douleur et Analgésie 32:2, pages 105-107.
Crossref
Jenna Goesling & Mark Ilgen. 2019. Treating Opioid Addiction. Treating Opioid Addiction 239 256 .
Johan Kakko, Charlotte Gedeon, Mikael Sandell, Henrik Grelz, Inge Birkemose, Thomas Clausen, Valgerður Rúnarsdóttir, Kaarlo Simojoki, Richard Littlewood, Hannu Alho & Fred Nyberg. (2018) Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice. Substance Abuse Treatment, Prevention, and Policy 13:1.
Crossref
Stefan G. Kertesz & Ajay Manhapra. (2018) The drive to taper opioids: mind the evidence, and the ethics. Spinal Cord Series and Cases 4:1.
Crossref

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.