Opioid Tapering Guidelines

McMaster University > Michael G. DeGroote National Pain Centre > Canadian Guideline for Opioid Use for Pain — Appendix B-12: Opioid Tapering:

"Rate of the Taper
The rate of the taper can vary from 10% of the total daily dose every day, to 10% of the total daily dose every 1–2 weeks.

• Slower tapers are recommended for patients who are anxious about tapering, may be psychologically dependent on opioids, have co-morbid cardio-respiratory conditions, or express a preference for a slow taper. 
• Once one-third of the original dose is reached, slow the taper to one-half or less of the previous rate.
• Hold [or increase] the dose when appropriate: 
• The dose should be held or increased if the patient experiences severe withdrawal symptoms, a significant worsening of pain or mood, or reduced function during the taper."

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