Abrupt opioid cessation can
cause serious harm to patients
photo: istockphoto.com
P
By Drs. Pamela Leece, Sheryl Spithoff, Meldon Kahan
olicy makers and medical organizations are encouraging physicians to prescribe opioids more
cautiously. Changes to prescribing guidelines and public opioid drug
coverage are intended to increase patient
safety; however, there may be unintended
harms while reducing opioid prescribing
to safer levels. Particularly, rapid tapers
and abrupt cessation of opioids can cause
patients extreme discomfort and significant harm, including risk of overdose if
they resume opioids again.
As we work with our patients to navigate
challenges in managing pain and addic-
tions, and improve their health outcomes,
we must be mindful to follow a compassionate, safe and evidence-based approach.
What scenarios may lead to abrupt
cessation of opioids?
Patients who develop an opioid use disorder often display aberrant behaviour such
as frequently finishing their prescription
early, making demands for treatment refills
and dose increases, and often escalating to
opioid doses far in excess of what others
with their pain condition need. At their
clinic visit, they often report severe pain,
low mood and function, yet resist any
Issue 3, 2016 Dialogue
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