Pilot Study on Voluntary Opioid Tapering Shows Interesting Results

Pilot Study on Voluntary Opioid Tapering Shows Interesting Results

By Ed Coghlan.

A pilot study about tapering off opioids published this week from a single pain clinic shows a potential method for effectively tapering patients on high-dose opioids without increasing their pain. That’s what study co-author Beth Darnall, PhD of Stanford Pain Clinic wrote this week in describing her research team’s work.

“Many patients are fearful about reducing opioids. Our study methods focused on providing education to help allay their fears, as well as strengthening that bond to help patients succeed and achieve best outcomes.”

As the study report indicated: “Because our data are generated from a single pain clinic, studies are needed to assess how well our protocol would generalize to other types of patients and settings.”

Dr. Darnall agreed to answer a few questions we had.

National Pain Report: “It looks like you believe this study can lead to more research about people who are looking to wean themselves from opioids, right? Is that that right way to look at the “n”…people who want to wean themselves?”

Dr. Darnall: “110 patients taking long term opioids were invited to participate in a voluntary, patient centered opioid taper. They were promised it would go slow, slower if they wanted, and they could pause the taper if they wished. The goal was not zero opioids, it was to reduce their dose as much as comfortably possible over 4 months. We were interested in understanding who would express verbal interest (N=82), who would actually *engage in* the voluntary taper (N=68 filled out a baseline survey), who would complete it (N=51 filled out a final month 4 survey) and what would be their results. Finding that about half of 110 patients who were simply *offered a tapering pathway and nothing else* actually chose to do so was quite interesting. We believe that is because it was a patient-centered approach.”

“This pilot study is of the first to suggest that approaching opioid tapering differently – not forcing patients but partnering with them – may have a positive impact on their outcomes. Basically, for free. The pre-post within-subject nature of the study, combined with objective and subjective data, the topic and desperate need for tapering guidance for physicians and patients make this an important study that can help guide future work.”

National Pain Report: “What happens next, do you have a multi-center study in the future? What will that study explore?

Dr. Darnall: “We are now studying these methods in 865 patients in 5 clinics in 4 Western states beginning July 1. Similarly, our upcoming study is voluntary, patient-centered opioid reduction. We are also testing two evidence based behavioral strategies to help improve taper response and improve outcomes (this is an embedded RCT). The JAMA study is the pilot work to suggest we may have a successful method *for some patients* and we are now setting out to do the definitive science. The Patient Centered Outcomes Research Institute is funding our study. Patients were involved in the design of the study and will be involved in all aspects of research.

National Pain Report: “There’s an interesting number…a relatively large percentage dropped out of the study. Do we know why? Did they not to wean themselves from opioids or were there other stimuli?”

Dr. Darnall: “Only 17 out of 68 who enrolled in the taper study dropped out. It’s a 25% drop out rate and it is less than expected, frankly. We see about the same in non-opioid research studies. We don’t know why, but for whatever reason our study failed those 25%. We need to study this group more and learn from them. But it also in no way negates the positive findings:  that a simple formula appears to help reduce risks for many patients without increasing their pain. I should clarify that the taper formula is simple, but patients need to trust their doctor and be willing to try to reduce their opioids.”

National Pain Report: “What did the overall results tell you as a pain researcher and noted psychologist?”

Dr. Darnall: “Forced tapers don’t work. Patients heal through compassion, and the doctor-patient bond is so important. We must address patients fears and cultivate partnership to achieve best outcomes. Gaining patient willingness to reduce opioids is critical to the success of a taper; at least, this is what I believe… we are now conducting the larger study to understand this more.

National Pain Report: “One final thought…do you have thoughts on how many people who are using opioids to manage chronic pain are capable of tapering to the point of finding other ways to manage their chronic pain…Is that even a question we can ask at this point?”

Dr. Darnall: I think our upcoming PCORI funded study will address this point – at least in part.”

Here’s a link to the research study published this week.

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Authored by: Ed Coghlan

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37 Comments on "Pilot Study on Voluntary Opioid Tapering Shows Interesting Results"

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Thanks Sandy,

My Mother refused to even consider what could happen. She was very clear about not wanting to go into a Nursing Home. I tried repeatedly to get help from various Social Service Agencies over the years. I had no idea that my sisters were working behind my back. When they started a Medicare Insurance program, I took her to the presentation, along with another senior lady. She could barley hear the presentation. I though I had explained the need for insurance, sure enough though, my sisters told her it was a Plot.
My Mother probably had Lewy Body Dementia, it is different from Alzheimer’s. When people have a condition like that they can become paranoid, and my sisters fed her paranoia. They lived over a thousand miles away, they were not there for day to day things. What they did is called Gas lighting. It was easy for the to manipulate her and demonize me, because I was the one there. The Lawyers made a lot of money too, so they kept this going, Our state has no real protection for the elderly or even children. The cut so many positions, and removed competent people.
Our State failed to even monitor the Nursing Home, which was the subject of multiple Lawsuits, Fines, and failure to comply with basic regulations. They let people die, rather than provide decent care. It was a horror show. These Companies are above the law.

sandy auriene sullivan

Kathy C, Bless you and your mother. Mom expects issues ahead of time. She knows I’ll spare no expense to keep her alive; while my sister would keep her going on the ‘cheap’ because what’s left goes to us.

Im grateful for her trust in me to make me a dual executor with my sister. For 20 years I was the sibling my parents were told never to ‘trust’ [it didn’t help my 1st 12 years after moving out of home – I moved to another country! Didn’t get to see them as often].

It took twice a year visits, which I do to this day [even stay in mom and dad’s RV if they are in the mountains away from the humidity of MS] for them to get to know me as an adult; alone.
We enjoy each other’s company a great deal, making up for lost time. Dad figured it out first [step-dad 26yrs] telling our mother that the only child that’s going to be a ‘problem’ is the eldest – my sister. The one who still tries to put me down and it backfired last time. Was at the parents for 10 days because they came down with flu within days of me arriving for Thanksgiving.

My sister had this huge family breakfast while I was there…. with one of my sons [he was bullied in going along]. But didn’t invite me, only Mom and Dad. When my mother saw the texts she had sent to my son about going there instead of visiting me? Mom blew her top! She never does but she had a good high grade fever.

My time with my parents has been a blessing; Im sorry for all the rubbish your siblings put you through without a proper resolution with your mother. Soon as mom had her first emergency ER visit; she went to the lawyer within 72hrs to make sure my sister did NOT have full control over mom and dad’s finances. They have it wired tightly with the lawyer and the little that my sister and I will be responsible for – forces us to get along while we make decisions. Hopefully, we’ll not have to work together and the lawyer handles it all. It would mean no protracted illness.

Well put April,
As things like drugs become cheaper there is not incentive for business to promote them. Once drugs go generic then all the profit is gone. “Let’s sell them something else”.
Capitalism drives everything. How much can the market bear to pay, Insurance is the same way. As long as they have a positive cash flow everything is all right.
Take automobile insurance for example. You pay premiums for years and then you have a couple of ACCIDENTS and your premiums go up.
Healthcare did the same thing with pre-existing conditions. Obamacare was to fix that but then the AMA met and said it was not unethical to deny treatment to someone with comorbidities.
Cherry Pick and Lemon Drop AMA-March 2016

Sandy Arlene Sullivan,
They turned my family against me too. When my other developed Dementia, they used my condition to attack me in Court. I had turned to them for help, when she could no longer mange her affairs. Instead of helping, my sister was calling her and telling her I was going to “Put her in a Home.” As I tried to get Medical Care for my mom, they were calling and terrorizing her, telling her not to listen to the Doctors or comply. They were after her money and property, and all they had to do was tell the Court was that I was a “Drug Addict.” I had asked for a worker from our States Social Services to help, instead they painted me as “Mentally ill” because I was injured working on the house where my mom lived 25 years ago.

My mother ended up breaking her hip, under suspicious circumstances, and was put in a Medicaid Nursing Home. She had the money for decent Insurance, but my sisters told her it was a bad idea. I had tried to enroll her in the Medicare Part B. I had no idea when I was driving her to these Sign Ups, that my sisters were working behind my back. When my mothers Physician told her she needed oxygen, my Sisters went nuts and told her it was a Scam. Her Oxygen levels were in the 70’s. She would Blank Out anywhere even driving. When I tried to get her to stop driving my sisters told her I was up to something. This went on for years, I had no idea how evil some people are, when it comes to money.
My Mothers condition was never diagnosed, even though I had to try to get referrals for years. I had unfortunately told my sisters by email about he medical visits, they used that against me too. My Mother Hygiene suffered as her condition worsened, and she would get angry at me, if i suggested a change of clothes, if we went out. She also refused shower or bathe. Her Physician and the Social Worker at her clinic did not even acknowledge that, it was a sign of deteriorating mental state. I found out years later that the Neurologist I took her to, had a Brain Tumor. She was incapable of making and accurate Diagnosis or even provide me any insight as to what to do.

One of my sisters even used my mother Credit Cards, racking up thousands taking her kids to a Hotel on weekends. This was while my mother was languishing in one of the worst Nursing Homes in the Country. There was even a Class Action Lawsuit against the Nursing Home, but i did not have the energy to join it.

sandy auriene sullivan

Kathy C,

You are spot on about it turning family and friends away. Ive been dealing with stigma for 2 decades. At first my spine didn’t show how it was going to herniate down from c-4 to t1 and like dominoes keep going…. not at first. Now it shows signs of CRPS too.

Had siblings call me a junkie, tell me there’s nothing wrong with me. Had harassing texts from family over the years. My brother especially since he’s fought cancer off and on for 14yrs now; he’s always had pain since he went into a remission for 13yrs. He just couldn’t afford the doctor for pain medication. So he did what any middle child does – pinches the youngest. Lol.

Today he is more understanding. After I had to have my mother step in and say something. Here we are, Mom is pushing 80 and she’s telling off her kids who are 60, 58 for picking on their 46yr old sister. Mom has always stood up for me; when talk would start out of my view or hearing – at every family gathering. The fact that invisible illness little sister needs disability and pain medication… and and *gasp* cannabis too?! They were shocked to find out she supported me; for all of it.

You don’t need everyone to have your back. You need at least 1 or 2 in the family. 1 inside your home and one within immediate family.

Ive flat out shown my exams, my scars and bring someone with me to an appointment whenever they’re in town. Have no clue how those who have no one; emotionally or physically can *do* it.

sandy auriene sullivan

Statistics on health are the most abused data stats out there.

We have approx 60k in *suicides* a year
Approx 50k in car accidents
another 35-40k [opiate related deaths – illegal and legal. Multidrug toxicity OD; but yes, long said if I die w/my meds in my system I become an opiate stat instead of ‘we’re sick and sometimes we die, when we do do not be shocked to find out meds in our system too’]

The one that gets me is suicide. Those stats have been tacting upward steadily for just 5 years! All known cases of suicide are listed in that bracket. If we have to have a ‘war’ on something I’d suggest policy makers look to “Reasons why people take their own life”
As that seems to be the biggest threat.

Otherwise, toting water for the addiction centers [who received 50 billion dollars in 2015 and set to get MORE] and addiction drug manufacturers is what our news does today. Talks up a brand or has a special consultant on to discuss their brand/s product while making it seem like a segment not an infomercial. Just remember infomercials are their bread and butter.
Bad stats? Look to who gave their producer that information and who has what to gain.

Remember that the Owners of CBS and the other big media corporations, profit from this misleading false narrative. Stoking confusion, fear and misleading information is their stock and trade. When we ask, Who benefits? Remember that the media owners have millions if not billions to be made in the mayhem. They own stock in the all of the corporations that benefit from the “Epidemic.” The Fact that people are still dying, not just from Opiates or Heroin, but from other prescription drugs, despair and hopelessness, is left out of the “News.” They feel justified in reporting the inflated Statistics, they get more attention, that way they can appear to be “Spreading Awareness.” Advertising and media created this “Epidemic” and they continue to profit from it. Just like this “Researcher” that is promoting her business, and beliefs..

Just watched “Sunday Morning” (CBS) on the opioid crisis (Feb.25, 2018). The producers treated the government’s statistics on opioid-related deaths as if they were the Word Of God — instead of a flawed data collection system. Those 60,000-plus deaths per year include any death in which the deceased had recently taken opioids, including their own prescription opioids.
They also left out the fact that many of the deaths were NOT due to opioids! The statistics included heart attacks, car accident, alcoholism, drowning, cancer and (of course) smoking-related morbidity. But anyone who had even a trace of opioids in their body at the time of death was counted as an “opioid-related death.”
The statics weren’t differentiated by legal versus illegal opioid consumption, either. People who died (from all causes) while taking their own prescription opioids weren’t separated from those who died while using illegal drugs. If I’d submitted a set of statistics this seriously flawed to my Stats 101 professor back in college I would have flunked the assignment, and possibly the entire semester!
I’m shocked that CBS would put out a segment this badly skewed. I’d expect “advocacy journalism” from the government, the CDC , the DEA and Fox News, but an independent news station? Accurate statistics require far more detailed reporting and accountability than was shown by the government and, sadly, by CBS.

This is starting to sound more like an addiction blog. We are not addicts.
Stanford put out a survey and question request mid 2017. Sign up and get a free 25 dollar visa gift card.
Some kid is working on a graduate degree and using this info to write a paper.

They deliberately conflated pain patients with junkies, that way the Medical Industry can deny them treatments, and due to the stigma, none of us have a voice. They have also turned friends and family against pain patients. This researcher relies on demeaning and dehumanizing Pain Patients for her research funding, and book sales.

sandy auriene sullivan

“Stop treating pain patients like junkies. In fact, stop treating junkies like junkies too,”
*applause* For that line but really for the entire post Marco!

I couldn’t agree more. If pain patients are being shafted; then junkies are 21 Century leprosy! Many patients lumped in for the heck of it. We benefit as a whole if we worked across these 2 communities; which policy has forced together anyway.

Well said Marco!

I would like to say that I have been on the exact same amount of opioid medication for over 10 years – the exact same amount. I have tapered off for a few days of one of the 2 pain medications I am on – my doctor said that helps keep the medications working at the same amount. I have also (and continue to) try all kinds of supplemental treatments – everything from herbal adaptogens (to reduce anxiety which helps reduce pain), to massage, chiropractor, physical therapy, water therapy, and on and on. I want to try more and do more, but it is so expensive, and almost none of it is covered by insurance. To really successfully treat pain, each person must be treated individually and as a whole person. I suffer from many different forms of pain and they require completely different treatments. But things like massage, having a warm pool to swim in, specialized yoga for people like me, healthy organic meals paid for and made for me, specialized physical therapy – these and more work very well and would most likely allow me to reduce my opioid medication – but as I said before – they are very expensive as they are needed for a life time and not covered by insurance. I can’t even find financial help to get transportation to these kinds of treatments, let alone paying for the treatments. And I can assure you that none of these experiments would be able to include and provide years of the secondary treatments that would actually help. People just aren’t willing to look at the long term financial cost of treatment, so instead they leave us with the long term physical, emotional, and spiritual cost of our lives being systematically destroyed, day after day, month after month, year after year, until we either get help with opioid medication or some other medications that help or end our torture with suicide.

To Scott M.
Scott I am pretty sure I see you post quite often on NPR, consider yourself lucky as to your m.g. level of 120 of oxycodone because that is twice the 90mme limit per the CDC. Probably 6 20m.g. a day ,1 20mg tablet every 4hrs is your dose I figure.Your doctor is is not in line with the CDC 2016 guidelines.He must not fear their intrusion into his office and his patients medical records,if he does this with most or even some of his patients a team of Stormtroopers thru his front door is inevitable!

And no, try your best to not run out completely because will test your will to exist,AND it will be disobeying the instructions on your pill container.

Marco – I don’t have the words to adequately thank you for writing this response. It is so hard to be articulate when you are in so much pain you can’t think clearly. And during that short period of time I get a small break from the pain (the pain is reduced by opioid medication, bu never completely gone), the last thing I want to do is take on a battle I should never had to fight in the first place. I want to use that precious time to go and spend time with friends, or help contribute to my family life – doing chores, or self-care, go on a short walk or do something spiritual or anything this is life affirming. Side note – over and over again 99.9% of doctors and “experts” insist that taking opioid medication will cause people to stay at home and be anti-social and rot away their lives doing nothing – they could not be more wrong – they have it backwards. How can you be spiritual or have a loving sexual experience with your partner or go out on a walk, or anything, when your pain is so severe you can’t move. Sometimes I really wish I had the power of instant Karma for these people. But anyway… thank you for being the voice for so many of us. I deeply appreciate it. And how would you feel about me quoting some (or a lot) of what you wrote on a facebook group (but keeping it anonymous if you want? I just think your words are truthful and healing and would be good for many to read -both those who are suffering pain and those treating (or not treating) it.
One more note – sometimes I do wonder if part of the problem goes to our county and religion. It seems like anything that even hints of pleasure (i.e. the possibility of the “high”) is evil and wrong and suffering is actually what their God wants us to do, or something like that. I am not articulating it very well, but it feels like that sometimes. It reminds me of the religious movement of trying to rid the world of, “The demon liquor” with one big difference. This is medicine! For pain so severe it will cause people to end their lives. Living with severe chronic pain is a from of torture – period. Doctors are failing to keep any sacred vows they made about treating their patients when they put the political/religious agenda of the “war against drugs” above the medical needs of their patients.

It’s great that some patients were able to taper down. But why so much focus on lowering doses? Shouldn’t the focus be on quality of life and pain control?

I remember 20 years ago being told by some doctors that “pain patients cannot become addicted to opiates”, which at the time I thought was complete BS. Basic knowledge of how opiates work will tell you that.
Today we are being told that because a bunch of people took opiates recreationally, we all have to be punished and have our pain undermedicated. It makes no sense and it comes from the same ignorance as the previous statement.

After many interactions with doctors, pain clinics and other professionals, I figure that with more than half of them this obsession on sobriety comes not from serious scientific inquiry on pain and addiction but from a moral stance.
They don’t want addicts. They believe addiction is a weakness of the spirit, not a consequence of trying to manage blinding, unbearable pain.

If there are patients out there that want to taper off, for whatever valid reason they have, that’s great. But I can’t help being suspicious that this data is going to be utilized to eventually force more pain patients into sobriety for the sake of cleaning up the mess their profession made in the past.

If my choice is between addiction to opioids or addiction to pain, I will take the opioids anytime because they allow me to walk around, do chores, play music, watch a movie. Live life.
Pain doesn’t let me do that. Pain is a bubble that envelops you and prevents you from living life. It takes away your humanity.
The pendulum needs to start swinging back and this time it would be nice if we made it stop where reason, science and compassion converge.
Stop treating pain patients like junkies. In fact, stop treating junkies like junkies too, because even those that started out taking opioids recreationally, are now patients in need of help and understanding and cutting them off with prejudice can only result in more tragedy. For those that don’t have an underlying pain issue, these programs can be just and necessary, but if we make no distinction between the two groups and we treat all of them as potential criminals and addicts you will see a lot more “overdoses” and a lot more death.
We have to stop looking at opiates and addiction as a scourge. Addiction is NOT the worst thing that can happen to a person. Pain is. We call it Torture.

Compassion. Let’s try that for a chance.

sandy auriene sullivan

Did she substitute any of the medications? Was zubsolv or suboxone used as an alternative? As it was for me, so far Ok. With the additional legal MMJ in my state [another complex process that means working very closely with a doctor who is not your primary or other specialist but a separate specialist here in Florida]

Because the best results for reduction seem to be when another medication is added in; and not just me. We’ve heard of people going off opiates for cannabis often.

I do not push that pressure on myself and my doctor has been very kind of late; realizing that not only am I compliant/willing to work with my doctor but in a LOT of pain. He is ruling out cancer again. In all honesty because he doesn’t want to have to treat CRPS. Which is the most obvious issue going on with my left leg/foot.

Dr. Darnall, Thank you! ever so much for taking real interest in finding a way to truly help our community. I wish you the best! Please keep us informed.

I love you too Mareaeric.

Love in Christ dear friend!

I made a negative comment and would like to add that at least the tapering was not forced. I applaud that!

I have been forced to wean from high dose 240 mg oxycontin to 120.
I continue to tell my dr my pain is crippling and I have become a painful spectator of life then a participant.
I have gone thru hoops trying to get my dose back, only threatened to be dropped by kaiser.
I’m bedridden and now not only in constant bodily pain but I have become very depressed and agoraphobia. Walking 100 ft causes me so much pain I can pass out. I’ve told them my old dose worked for 7 years. I should not he punished because drug addicts are shooting heroin. I’ve passed every UA TEST AND my medicine always lasts a month. I constantly want to take more medicine but then I will run.out early and then only God knows how I would feel

I have received the National Pain Report e-mails for awhile now. I now understand that there are so many peiple that are in the same boat I’m in, relentless chronic pain which is not covered enough that we can lead a “normal” life, and function enough to even do simple house work. As I read everyone’s comments it is so pathetic, it makes my heart so heavy. The one thing I can liken our treatment to are those within the bible, who had Leprosy. They were ignored, mistreated,
abhorred, and were separated from all others. This is WRONG in so many ways! I just want all those who hurt so badly everyday to know that I love you and I understand, and one day, we will meet our maker, He will wrap his arms around us, wipe every tear from our eyes and say, “there will be no more crying or pain.”

There should be a lot more studies like this. Pain is way understudied and researched. Hardly anything is known about it. The govt should stop their crusade until they have a lot more studies done and more is known.

I have looked and searched for information about pain levels after people wean down or off opioids. I have weaned down 30% before (I am not on high dose), and then my pain was unbearable, so I resumed regular dosage. Does withdrawal pain settle down and become manageable for some or many People, over time? I was hoping the study would tell, didn’t see that info.

yes i am agree with it this method of treatment is really effective and great .
Thanks for this great article. Especially it works on Neck, Spine and on Foot and also for back pain

Please I beg Washington, and even my state, to walk even a block in my shoes. None of you could do it. Have you ever considered allowing chronic pain pts., To be freely treated by Doctors without tieing their hands behind their backs. Many people in pain become desperate to get some relief even for a few minutes, so they will accidentally over dose on all kinds of pain medication, not just opiods. They cry for relief. If you folks who don’t have 24/7 pain would just stop, just get off trying to control everything. Perhaps if a person’s pain could be truly treated with an integrative approach we could afford there would not be the desperation to figure it out themselves. You all put controls on the medications, the drug people, and street addicts will still get it. You need to look at how many people not in pain get it and mix it together with everything, overdose and die. We the chronic pain pts die from our disease, the majority of the time, and we suffer, every second of the day. I feel we have been labeled the scourge of society. ” It’s their fault people are dieing.” ” We have to save the people from themselves, we have to stop all narcotic pain medication.” Give me a break. I am not an idiot. I can think for myself. None of you folks who are in that white house live in the real world. You honestly have lost touch with regular people. Get rid of it. The street drug users will still get it. You will have more deaths from chronic pain pts., Because they will not be able to deal with their suffering.

Plainly put you are a victim of elder abuse.
I would file a complaint with the state health department. They take these complaints seriously.


I’ll have to see this study replicated a few times b4 I put much faith in it!

I don’t think this would work for me. I have cervical and spinal stenosis, plus bad scoliosis. My clinic doctor said she could not give the amount of pain meds that I have been taking for the last ten years. I have been taking 6 30mg oxycodone for the last 7 years and similar dose of Oxycontin for ten years before that. She lowered my dose 1 30 mg tablet a day immediately. After 4 days,I am in a lot of pain and have withdrawal symptoms.

I wish to withhold my name

My question would be, “how is it that the patients who tapered off opioids no longer had pain worthy of opioid treatment?” Were they inappropriately prescribed opioids in the first place for acute pain that resolved itself? Were they suffering from opioid induced hyperalgesia ( OIH, the existence of which remains controversial) and when tapered off opioids the hyperalgesia was resolved?

This is the question that I asked my former pain management doctor when he told me that I needed to taper off high-dose opioids for a incessantly painful cervical spine condition. He said that I would thank him when I succeeded in this because I would ultimately feel better. My question to him was, if early on I needed opioids to treat my cervical pain, and I have been successfully managing this pain with opioids for eight years, why would we expect that I would “feel better” upon eliminating my opioids? Was he suggesting that my discs spontaneously healed themselves and that my C1 and C2 nerves were no longer compressed? He replied that opioid-induced hyperalgesia was the source of my pain. I said, for the sake of argument, let’s assume that I have OIH, and I taper off opioids, and I lose the pain associated with OIH – would I not still have the underlying pain associated with my compressed nerves, and was this not the pain that had me nearly bed-ridden prior to opioid therapy? At this point had no answer for me, other than to say that I needed to taper of opioids. With this it was clear to me that his decision was driven by a new opioid policy within his practice, and not by what was best for treating my medical condition.


What an amazing statement, “patients heal through compassion…”.
My specialist (a neurosurgeon) could care less about me. But my GP is the most compassionate doctor I’ve ever had. I honestly feel better after I see him.

What does it mean to reduce risks without increasing pain? The part that the author seems to have made a firm conclusion too.

And I didn’t see anything about reducing pain. Maybe one reason for the lack of participation is that for the patient – what is the incentive to reduce opiods but still be on some opiods in the end? I mean, speaking for myself only, I have had mine reduced forcibly, like so many others. Being a person in chronic pain, you naturally go through these emotional gymnastics, whatever you need to do, to convince yourself that these lesser meds ARE going to work and I WILL adjust! It’s just what you go through mentally when forced to taper.

But the harsh reality sets in that 1. -I tried, 2.- It’s not working, my pain is not adjusting to this lower dose, 3-in some cases it’s not responding well to this new medication, and, 4-offering up my sincere prayers to the one who can definitely give me relief-my Lord and Savior Jesus Christ.

That’s my own experience with tapering. You can call it both forced, and sort of willing too because I felt for my own sake that I needed to start the process in the positive, that this IS GOING TO WORK, because that’s what my doctor said should happen. Mind you, I didn’t really believe her when she reduced me, but I still had to get through it, so better to do it with the best attitude I could muster up.

Here is what tapering has done to me. – Eventually I had to go back up to my full dose. My pain became literally unbearable. Getting to the bathroom was impossible without a walker AND a mountain of crying out loud pain.

The kicker was, my pain was much, much, much, worse than before the taper! I wish I had the answer as to why. Why is this happening to me? My doctor has my dose doubled now, and I tell you right here – IT IS NOT ENOUGH FOR ME TO LIVE LIFE.
I went from a walking person to a non walking person, because of sheer under treated pain.

I wish you well with your study. I pray it leads to MORE QUESTIONS first, so ALL of them can eventually be answered.

God bless you for doing This work AND TRYING.

I think this is a very important study and yes, the findings were interesting. The key here is to have faith in their doctors. The whole opiod crisis has had a very profound negative impact on many chronic pain patients. People have been afraid that their meds will be restricted or cut-off altogether, without anyone asking them how their symptoms are. I think we may be on to something here if….the government keeps their nose out of the doctor/patient relationship. Allowing people to volunteer or not is key and compassion is so very important. Another important aspect needs to be that the doctors do not have to constantly fear reprisals from the FDA/DEA. Doctors need to be doctors again. Not having to worry about the Feds raiding their clinics and patients need to be able to find doctors in whom they can trust again. Especially the ones who have been casualties in this so called opiod crisis. If the government can keep their nose out of this and if doctors can trust their patients feelings and symptoms, I, being a nurse and a pain patient, think this might be an option for some if not many chronic pain patients. Allowing them to have a REAL parterniship with their doctor/caregiver team might just have a fighting chance at reducing the opiods that each individual takes. Forcing people do anything just will not work on any level and more likely will have a negative impact in people’s lives to the point of hopelessness and possibly suicide if their symptoms are not addressed. So, BRAVO to the pain clinic and their pain patients who participated in this small but important study. I personally would like to see this be an option for all chronic pain patients without forcing anybody to do anything. People know what their pain levels are and when they are allowed to be the driver of their own care I would not be surprised if chronic pain patients will seek out other modalities for treating their symptoms. Finally, if doctors are allowed to be doctors again and not constantly fearing reprisals from the government, chronic pain patients care will definitely improve. Thank you for bringing article to the forum.


“There’s an interesting number…a relatively large percentage dropped out of the study. Do we know why? Did they not to wean themselves from opioids or were there other stimuli?”

My SWAG is that 25% had Intractable pain. I would describe it as a quality of pain that feels acute but is always preset due the type of organic disease they have.

What kind of motivator was given to enter the tapering trial? A $25 gift card or other monetary prize?
Just curious.

Exactly my point, patients in Michigan are forced to stop without any draw downs or modes of other treatments. I was on morphine for 4 months 15mg 3 times a day and 2 Percocets, and my new pain management specialist told me to shut up, I wasn’t going to get what I was previously given. He took it all away…I went two weeks with withdrawals like I have never felt in my life. Not from the Percocets, from the 4 months of being on morphine. I couldn’t take it and asked my Primary care doctor to give me a referral to a different doctor in a office I previously went to before they dropped me because the doctor didn’t want to prescribe me my medications. Thank God he saw me, he new exactly what I have been suffering from all my life, and ordered new ultrasounds and tests to confirm what has long been thought. I’m now back on my regular meds without morphine thank God.