A systematic review of 44 studies found mixed evidence for opioid tapering interventions in chronic non-cancer pain, with no clear difference in pain severity between intervention and control groups across most studies.
- Evidence for specific opioid tapering interventions is uncertain and of low quality
- Most studies showed no difference in pain severity between tapering and control groups
- No serious adverse events were reported in any of the included studies
How this compares to prior research
Opioids have been widely prescribed for chronic non-cancer pain management, but accumulating evidence does not support their long-term use due to important limitations. Prior to this review, the evidence base for specific tapering interventions remained unclear, with uncertainty about which approaches safely and effectively help patients reduce or discontinue opioid use. This systematic review aimed to consolidate existing evidence to inform better clinical pathways and service design.
Chronic pain prevalence among adults, global estimates, 1990–1999
Key findings
- Seven of eight comparative studies found no difference in pain severity between intervention and control groups during opioid tapering
- The proportion of patients who successfully ceased opioid use varied widely across studies, with some evidence of later relapse
- Males and older patients experienced poorer tapering outcomes, suggesting potential inequalities in treatment success
What this means in practice
- Ask your doctor about tapering support if you have been on opioids for chronic pain for more than 3 months
- Expect your pain levels to remain stable during supervised tapering based on current evidence
- Request wraparound support services during tapering to improve your chances of success
Frequently asked questions
Is it safe to reduce opioid use for chronic pain?
The review found no serious adverse events reported across any studies. Most patients did not experience increased pain when tapering with support interventions.
Will my pain get worse if I reduce opioids?
Seven of eight studies found no difference in pain severity between people who tapered opioids and those who continued. Pain levels generally remained stable during tapering.
What helps people successfully reduce opioid use?
Success is more likely when care is patient-centered, both patient and doctor are willing to taper, and the patient receives wraparound support throughout the process.
Key terms explained
Opioid tapering
The gradual reduction of opioid medication doses over time to safely decrease or stop use
Chronic non-cancer pain
Persistent pain lasting more than 3 months that is not caused by cancer or cancer treatment
Systematic review
A comprehensive analysis that collects and critically evaluates all available research on a specific question
Source: Interventions to safely and effectively reduce (taper) use of opioids in chronic non-cancer pain: a systematic review. · DOI: doi: 10.3310/GDWP3572