Opioid Tapering in Fibromyalgia Patients: Experience from an Interdisciplinary Pain Rehabilitation Program

Abstract

Fibromyalgia patients on higher doses of opioids were tapered off over a longer period of time but no differences in withdrawal symptoms were seen based on opioid dose. Duration of opioid use did not affect the time to complete opioid taper or withdrawal symptoms. Despite opioid tapering, pain-related measures improved at the completion of the rehabilitation program.

Prescription Opioid Taper Support for Outpatients With Chronic Pain: A Randomized Controlled Trial

“…This finding is consistent with those in studies of inpatient pain rehabilitation programs, which have documented pain reduction with opioid dose reduction. 8,30,25, 22 …”

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

“…Noteworthy, as demonstrated in our study, the groups did not differ regarding opioid dose and pain intensity, which indicated that L‐TOT in some of these patients may be dispensable. In addition, considering the limitations of retrospective designs, there are studies that reviewed patients’ charts and reported improvements on pain, mood and function following interdisciplinary rehabilitation programs for CNCP, which included opioid tapering off or cessation (Murphy et al., ; Cunningham et al., ; Huffman et al., ).…”

“…Noteworthy, as demonstrated in our study, the groups did not differ regarding opioid dose and pain intensity, which indicated that L-TOT in some of these patients may be dispensable. In addition, considering the limitations of retrospective designs, there are studies that reviewed patients' charts and reported improvements on pain, mood and function following interdisciplinary rehabilitation programs for CNCP, which included opioid tapering off or cessation (Murphy et al, 2013;Cunningham et al, 2016;Huffman et al, 2017). Another aspect of particular note was the fact that 58.3% of patients included in our study achieved stable treatment, which represents a high level of attainment compared to 34.5% of a previous available retrospective report in a similar sample (Schneider and Kirsh, 2010).…”

Perioperative opioid analgesia—when is enough too much? A review of opioid-induced tolerance and hyperalgesia

“…In patients receiving long term opioids, dose-reduction or cessation can reduce pain sensitivity, with many patients reporting improvements in pain, and few experiencing worsening of their pain (46,47). A recent clinical trial of opioid use for chronic musculoskeletal pain found that patients on long 7 term opioids had no improvement in function, worse pain, and more adverse events than those receiving non-opioid analgesics (48).…”