Starting a Conversation About Opioid Tapering with Patients

A resource for prescribers and health care providers highlighting the need for patient understanding and involvement in their medication management.

By engaging in thorough discussions with patients, we can gain a greater understanding of their needs and concerns in order to make appropriate changes for them at an individual level.

Key purposes of discussion points include:

• Increasing knowledge about the risks of long-term opioid use can encourage patients to reconsider how much they depend on medicine for pain relief.
• Empower patients to imagine change by exploring how they would like things to be different.
• Highlight the benefits of tapering to engage patients. Often, patients do not understand why their opioid doses are being reduced,4 and may find discussions about tapering confusing, as it is not usual to taper and discontinue a medicine that appears to be working.
• Allow patients to raise concerns they have about tapering. They may have had past experiences with reduced or missed doses and conversations can be rooted in their experience.
• Reassure patients that their medicine will not be taken away immediately, and that prescribers will not abandon them throughout the tapering process.
• Explain to patients that there are evidence-based strategies that can be used in conjunction with opioid tapering. Patients are often concerned that once opioids are removed nothing will replace them and the pain will increase.
• Inquire directly about patients’ expectations of pain relief and functionality. Having a common understanding is important to establish realistic treatment goals and set criteria for success.

NPS MedicineWise Opioids Conversation Starter