Rapidly forcing patients off highly addictive opioids can destabilize patients, lead to a worsening of pain, precipitate severe opioid withdrawal symptoms and cause a profound loss of function, medical experts warned in an open letter published in the journal Pain Medicine.
In the wake of the nation’s opioid epidemic, which took more than 48,000 lives last year, the U.S. Centers for Disease Control and Prevention (CDC) has advocated for tapering and discontinuing opioids in some patients who use them for long-term pain management.
But Beth Darnall of Stanford University in California, and coauthors, say that such “aggressive” dose reductions over specific time periods is “unrealistic.” Instead, she writes as a call-to-action to the U.S. Department of Health and Human Services, treatment should be patient-centered and patient advisory boards should be in place to ensure patient rights are protected.
Furthermore, health care professionals should use “compassionate systems for opioid tapering” in specific patients, she writes. Otherwise, patients forced to endure rapid tapering may resort to sourcing illicit – and in many cases, more dangerous – opioids. Others may become “acutely suicidal,” the paper warned.
“The assumption that forced opioid taper is reliably beneficial is not supported by evidence, and suggests significant harm,” said another coauthor, Ajay Manhapra of Yale University. It is also causing health care costs to rise due to the excessive use of other costly services like medical services, treatments and specialists, he said.
Source: Global News