- The number of long-term opioid users undergoing dose tapering more than doubled between 2008 and 2017, with women and patients taking higher doses the most likely to taper.
Why this matters
- Nearly 20% of those who tapered their opioid dose had a maximum dose reduction rate higher than the recommended 10% decrease per week to minimize withdrawal symptoms.
- Retrospective cohort study of patients (n=100,031) with commercial/Medicare Advantage insurance receiving long-term opioids.
- Rate of opioid dose tapering was analyzed (≥15% relative reduction in mean daily morphine milligram equivalents [MMEs]).
- Funding: University of California-OptumLabs Research Credit; Department of Family and Community Medicine.
- Patients had 174,822 periods of stable baseline dosing (2008-2017).
- The percentage prescribed long-term opioids undergoing dose tapering increased from 2008-2015 (10.5%-13.7%) to 2015-2017 (16.2%-22.4%).
- The adjusted incidence rate ratio (aIRR) in 2016-2017 vs 2008-2015 was 1.20 (P<.001>
- Patient-level factors associated with long-term opioid dose tapering:
- female sex (aIRR, 1.13; P<.001 and>
- higher baseline dose (≥300 MMEs/day vs 50-89 MMEs/day; aIRR, 2.57; P<.001>
- Limited generalizability of findings.
Coauthored with Chitra Ravi, MPharm