[To taper or not to taper opioids - that is the question].

Abstract

There is a lack of evidence for long-term opioid treatment of chronic non-cancer pain. According to European guidelines, opioids should not be used for primary chronic pains.  It is important to continuously assess the benefits and harms of each opioid treatment and, if indicated, discontinue it as early as possible to prevent an adverse trajectory. Long-term opioid treatment is a clinically complex situation in which the issue of tapering (deprescribing) should be considered. Tapering is a medical intervention that entails planned support and close follow-up. Potential benefits include increased safety, reversal of side effects, and an improved overall situation. Risks include acute and protracted withdrawal symptoms (including worsening pain) and impaired mental health. Problematic use of opioids (including opioid use disorder) occurs in this population, but prescribers should avoid a stereotypical and stigmatizing attitude.