How to Taper off Opioids

Opioids are among the most prescribed medications in the United States. These drugs are intended to be used as painkillers, but there has been an increased prevalence of recreational misuse over the last few decades. In addition to this, several illicit, non-medical versions of opioids have gained traction, namely, heroin, fentanyl, and others.

Of the approximately 64,000 drug overdose deaths in 2016, opioids were responsible for upwards of 50,000 of these. Opioids themselves are quite habit-forming compounds with a high potential for tolerance and dependence. Each drug, whether natural, semisynthetic or synthetic, binds to opioid receptors in the central nervous system. Once used, dependence can quickly develop. The intensity of the dependence on each user and their use behavior — but opioids are especially addictive, malicious substances when used recreationally or otherwise.

To call opioid use, addiction and overdose an issue is a gross understatement. The nation faces an epidemic. Millions of pills are being prescribed every year. States are doing their best to combat the crisis from every angle, but it will still take years to see if prescription limitations and legislation will have the ability to quell the spread of more potent opioids such as fentanyl. Truly, this appears to be where the real danger lies — cheaper and stronger opioid analogs that acquire new users from prescription dependences that cannot be financially sustained.

While the epidemic itself has yet to find a cure, it doesn’t mean that users themselves are lost. Far from it. Treatment is not only readily available across the country, but many methods have found to be effective in treating and recovering from opioid substance use disorders. In a clinical setting, physicians will often choose a detox approach as the first means of resisting opioid use. Whether from recreational use or from a dependence from use for chronic pain, tapering off opioids has proven to work for all kinds of opioid users.

Tapering Off Opioids | How to Taper Off Opioids
In order to better understand how tapering off opioids occurs, it is essential to know why it is done. Tapering, at its essence, is intended to circumvent or lessen the effects of withdrawal while allowing the body to adapt to life without the drug in question. Opioid withdrawals are uncomfortable, to say the least, and it is the fear of experiencing these symptoms that often prevents users from seeking help. Think of it this way. Users are either taking the drugs to prevent pain if they have a prescription or to achieve a euphoric high if they are ingesting them recreationally. Either way, whether to avoid pain or gain pleasure, this is the exact opposite of what a withdrawal is — painful and unpleasant. This is just one of endless reasons why an individual may avoid treatment. It is, however, the reason tapering exists in the first place.

Opioid withdrawal symptoms take many forms and levels of intensity depending on the frequency of use and the drugs used. Opioids and opiates fall into two distinct categories — short-acting or long-acting opioids — and thus these symptoms may arise at different intervals. For example, an individual consuming opioids with a short-acting formulation will begin to show withdrawal symptoms as soon as six hours after their last dose wears off. This can be as lengthy as 30 hours for the long-acting variants. Withdrawal symptoms that may be present include:

  • Aching of muscles, bones or soft tissues
  • Insomnia
  • Anxiety
  • Nausea and diarrhea
  • Runny nose or watery eyes
  • Profuse sweating or fever symptoms
  • Cramps in the abdominal region
  • Psychological symptoms such as cravings or depression

The abovementioned symptoms may occur anytime between the first few hours after the final dose to longer than 10 days. If you or a loved one is not in medical care for a detox, be sure to monitor withdrawal side effects closely. Though not common, some severe opioid withdrawals can have life-threatening repercussions if not dealt with accordingly.

Tapering off opioids seeks to lessen the burden of such withdrawals and allow the user to focus their energy and effort on achieving recovery rather than aggravating symptoms. Again, the intensity and scope of withdrawal are contingent on the user. So is the tapering method.

A taper is always incremental, but the speed at which this change occurs can be adjusted on an as-needed basis. Slower tapering approaches can span months or even years, while more rapid versions take place over days or weeks. Generally speaking, somewhere in the middle of the spectrum is considered best practice. With this method, physicians are looking to reduce opioid use by 5–20 percent every month. Similar methodology and an opioid taper calculator can be adopted for at-home tapers, though this is not recommended as a long-term alternative to clinical care.

The general rule of thumb for opioid use disorder treatment: if the patient is stable and used long-acting drugs, the slower the taper should be. And vice versa for faster tapers.

When determining how to perform a medical taper, doctors often use an opioid taper calculator. Known as a MED, or Morphine Equivalent Dose calculator, this tool allows physicians to convert a patient’s opioid-of-choice and the related dosage to a baseline opioid: morphine. From here, it becomes much easier to administer methadone, buprenorphine, or another replacement drug to begin treatment.

Opioid tapering can be a long, arduous process even for the strongest patients. While this can be done successfully as a self-detox process, it will require equal parts planning and persistence. For the best results, seek out medical intervention for yourself or a loved one.

 

Opioid addiction is difficult to overcome, but with the right treatment and detox care, anything is possible. The Recovery Village has helped countless clients overcome withdrawal symptoms and begin the recovery process in a safe, supportive environment. Reach out to an intake coordinator at  352.771.2700 today to get started. 

How to Taper off Opioids
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