If you or someone you love is trying to start opiate therapy, you may be concerned about withdrawal symptoms. Stopping opiate consumption and avoiding withdrawal symptoms are possible. To avoid withdrawal symptoms, your opiate use often needs to be tapered. Tapering means that the dose is gradually reduced until no amount is used. Your body slowly becomes used to the opiates not being in your system. Tapering opiates is one of the best ways to avoid withdrawal.
However, you should always talk to your doctor to try to figure out if an opiate taper is right for you. Opiate tapers should always be conducted under medical supervision, so you should never attempt it on your own. There are several aspects of opiate use that your doctors will take into account when you are tapering. These aspects include:
- Knowing the goal of the taper
- Finding out how long you have been on the opiate you are tapering
- Being aware if the opiate is short-acting or long-acting
- Knowing if there is dangerous behavior involved
What is the Goal of the Taper?
Different tapers can have different goals. Sometimes, the goal of the taper may be to stop drug use completely. However, this may not be true for all tapers. Sometimes, people may need to continue taking an opiate but are just trying to get down to a lower dose. A taper that is designed to lower someone’s dose may be designed differently than a taper that is designed to stop drug use completely.
How Long Have You Been on the Opiate?
In general, the longer you have been on an opiate, the longer your taper may take. This length is for several reasons, including the likelihood that if you have been on an opiate for a long time, you may be taking a high dose. High doses are common because of opiate tolerance, meaning that over time your body gets used to the low doses, so you need to take higher doses to get the desired effect. As it takes longer to taper off a high dose than a low dose, your taper may take longer if you have been taking the opiate longer.
However, if you are taking an opiate on an as-needed basis only and do not take it every day, you may not need a taper even if you have been prescribed the drug for a long time.
Is the Opiate Short-Acting or Long-Acting?
Short-acting opiates tend to stay in your body for shorter periods than long-acting opiates. Therefore, a taper for a short-acting opiate may be faster than a taper for a long-acting opiate. Understanding the type of opiate is essential to knowing how to taper from it.
Is Dangerous Behavior Involved?
Sometimes doctors need to do tapers as quickly as possible. Several reasons may push a doctor in the direction of a quick taper, like:
- If there are illegal activities involved
- If the opiates are being used by people to whom they are not prescribed
- If the opiate use is thought to be too risky to continue
Tapering Rates for Opiates
The Department of Veterans Affairs designed a few different common taper rates. Different patients need different taper rates depending on their reason for needing an opiate taper. The taper rates include:
- Rapid taper – takes a few days to taper the opiate. Your doctor may use this taper if there is dangerous behavior involved with the opiate use. The normal daily opiate dose may be halved the first day, and then reduced up to 20% per day until you are off the drug.
- Faster taper – takes a few weeks to taper the opiate. Your doctor may choose this taper if you have a substance use problem. The normal daily opiate dose may be reduced by up to 20% every week until you are no longer consuming the drug.
- Slower taper – takes a few months to taper the opiate. This taper rate is the most common and is used if there are no safety concerns. The normal daily opiate dose may be reduced by up to 20% every month until you are off the drug.
- Slowest taper – takes months or years to taper the opiate. Your doctor may use this taper if there are no safety concerns. The normal daily opiate dose may be reduced by up to 20% every couple of months until you are off the drug.
Opiate Taper Calculator
No one-size fits all calculator exists to taper an opiate. However, your doctor may use a Morphine Equivalent Dose calculator to figure out how much of the opiate you are taking. These calculators help your doctor by translating the dose of your opiate into morphine, which is one of the most widely used opiates. When your doctor translates your drug into its equivalent morphine dose, it may be much easier for your doctor to help you with a taper regimen. If you need opiate replacement therapy, it will be much easier for your doctor to figure out the dose that is right for you.
Is Tapering off Opiates and Opioids the Same?
Opiates and opioids are chemically similar. The only difference between them is that opiates are derived from natural sources, whereas opioids are synthetic in whole or in part. Opiates and opioids work on the same parts of the brain and body and are equally addictive. For this reason, tapering off opiates and opioids is very similar.
Key Points: Tapering off Opiates
Important points to remember about opiate tapers include:
- You should not try to taper an opiate on your own
- You should talk to your doctor before starting a taper
- Many factors go into designing effective tapers
- Taper rates and goals vary
If you or a loved one live with an addiction to opiates, contact The Recovery Village to speak with a representative about how treatment can help you live a healthier life. Calls are free and representatives are available at all hours. Call today to learn how addiction treatment can help you.
U.S. Department of Veterans Affairs. “Opioid Taper Decision Tool.” Published October 2016. Accessed May 25, 2019. Centers for Disease Control and Prevention. “Pocket Guide: Tapering Opioids for Chronic Pain.” Accessed May 25, 2019. Washington State Agency Medical Directors’ Group. “Interagency Guideline on Prescribing Opioids for Pain.” Published June 2015. Accessed May 25, 2019.
U.S. Department of Veterans Affairs. “Opioid Taper Decision Tool.” Published October 2016. Accessed May 25, 2019.
Centers for Disease Control and Prevention. “Pocket Guide: Tapering Opioids for Chronic Pain.” Accessed May 25, 2019.
Washington State Agency Medical Directors’ Group. “Interagency Guideline on Prescribing Opioids for Pain.” Published June 2015. Accessed May 25, 2019.