Physicians advise caution, collaboration with patients on tapering plans — ScienceDaily

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  • Opioid prescription doses are increasingly being tapered, often more rapidly than recommended : Physicians advise caution, collaboration with patients on tapering plans — ScienceDaily
    https://www.sciencedaily.com/releases/2019/11/191118100836.htm

    Baisser trop vite les doses d’opioides a également des conséquences dramatiques... la crise est là pour durer. Il faut la prendre en compte, et faire participer les Sackler et les autres profiteurs et organisateurs de la vente des opioides aux coûts d’une désintoxication réussie.

    Stigma and safety fears have made daily dose tapering of opioid prescriptions more common. New research from UC Davis Health physicians, however, shows tapering can occur at rates as much as six times higher than recommended, putting patients at risk of withdrawal, uncontrolled pain or mental health crises.

    The study — “Trends and Rapidity of Dose Tapering Among Patients Prescribed Long-term Opioid Therapy, 2008-2017” — is published in JAMA Network Open. The results also will be presented at the Nov. 16-19 North American Primary Care Research Group meeting in Toronto.

    “Tapering plans should be based on the needs and histories of each patient and adjusted as needed to avoid adverse outcomes,” said study author Alicia Agnoli, assistant professor of family and community medicine. “Unfortunately, a lot of tapering occurs due to policy pressures and a rush to get doses below a specific and sometimes arbitrary threshold. That approach can be detrimental in the long run.”

    They also found that the rate of dose reduction often was well beyond the CDC’s recommendation of 10% per month. The average reduction overall was 27.6% per month. Nearly 20% of patients tapered at a rate of 40% per month, and 5% tapered at a rate faster than 60% per month.

    The 2016 policy could have been misinterpreted, leading many prescribers and health systems to insist on faster-than-recommended tapering, according to Agnoli.

    “There is definitely a lot of pressure to reduce opioid use among patients, but there also is a need for more training and guidance for prescribers on how to help them safely do so,” Agnoli said.

    #Opioides #Désintoxication