Use of a Simple Pain Assessment Tool in a Shared Decision-Making Approach to Tapering Chronic, High-Dose Opioids

Because of the opioid overdose epidemic, over the past decade, efforts have been made to reduce opioid prescribing. However, tapering patients off their chronic opioid medications can lead to opioid withdrawal and increased chronic pain, use of illicit opioids, mental health crisis, and opioid overdose. Strategies for safely tapering opioids are needed because of these risks. This case report describes a 57-year-old male suffering from chronic back pain who had been on high-dose opioids for over 20 years. Using shared decision-making, a simple pain assessment tool, and a patient-guided taper schedule, he was able to taper off his opioids completely. This case highlights a successful opioid taper and presents simple strategies that can be used by patients and clinicians who are working to reduce chronic high-dose opioid use.