Tapering off long-term opioid therapy in chronic non-cancer pain patients: A randomized clinical trial

European Journal of Pain : EJP
G P KuritaP Sjøgren

Abstract

The indications for initiating long-term opioid treatment (L-TOT) for chronic non-cancer pain (CNCP) are often unclear and associated with problematic use. This study aimed at evaluating the efficacy of stabilizing opioid therapy followed by a sequential opioid tapering off program in CNCP patients. A randomized clinical trial with a medications stabilization period (Phase 1) was followed by an opioid tapering off program (Phase 2). In Phase 2, patients were randomized to Control Group (stable treatment) or Taper off Group (sequential opioid dose reduction) and assessed at baseline, after stabilization and up to 6 months. Primary outcomes: measures of cognitive function; secondary outcomes: pain, sleep, rest, quality of life, depression, anxiety, opioid misuse and opioid withdrawal symptoms. In all, 274 patients were screened; 75 were included, out of which 40 dropped out before Phase 2. Those who succeeded Phase 1 (n = 35) had weak/moderate improvements of psychomotor function (p = 0.020), sleeping hours (p = 0.031), opioid withdrawal symptoms (p = 0.019), measures of quality of life (p ≤ 0.043) and opioid misuse scores (p = 0.003). In Phase 2, patients in Taper off Group (n = 15) experienced stable pain intensity and felt sig...Continue Reading

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Citations

Mar 13, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·John A SturgeonPaul Coelho
Aug 2, 2020·Drugs·Stephanie MathiesonChung-Wei Christine Lin
Aug 14, 2019·Pain·Jane C BallantyneGeorge F Koob
Oct 29, 2020·Internal Medicine Journal·Paul GlareMichael Nicholas
Apr 17, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·David A Fishbain
Jan 28, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Jane AkhurstRaimondo Bruno
Apr 20, 2021·Frontiers in Medicine·Dokyoung S YouSean C Mackey
Jun 4, 2021·Journal of Substance Abuse Treatment·Sara Rodríguez-EspinosaJosé L Carballo
Jun 4, 2021·Journal of Substance Abuse Treatment·Colleen B MistlerRoman Shrestha
Aug 2, 2021·Scandinavian Journal of Pain·Anne Paarup PickeringStine Estrup

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