Once the taper has commenced, review the patient frequently, emphasize the benefits of tapering, and assess the response against the patient’s set goals.
If the tapering is progressing well
A successful taper is recognised by improved function, controlled pain and reduced side effects.
If the tapering is progressing well, taper to the lowest effective dose. This may mean stopping the opioid.
Some patients may not entirely stop using opioids, but any dose reduction is beneficial.
Note that the total tapering duration is difficult to predict, and each tapering schedule will need to be individualized.
If the tapering is challenging
Patients who are tapering opioids may encounter challenges during the taper. These may include increased pain, withdrawal symptoms, or previously unrecognized opioid use disorder.
If challenges are encountered, pause the taper and re-evaluate the patient’s goals, pain, clinical status, coping mechanisms, and tapering rate.
If the patient is experiencing withdrawal symptoms, consider simple supportive therapy or clonidine to manage symptoms.
Consider specialist input if the patient is experiencing serious challenges in tapering.
The algorithm ends here for these patients.