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Increased overdose and mental health risks persist two years after opioid dose reduction: Study found higher long-term risks of overdose, withdrawal and mental illness after opioid dose tapering

Does dose reduction for patients on stable opioid therapy have long-term overdose and mental health risks?

Researchers from the UC Davis Center for Healthcare Policy and Research examined the potential long-term risks of opioid dose tapering. They found that patients on stable but higher-dose opioid therapy who had their doses tapered by at least 15% had significantly higher rates of overdose and mental health crisis in the second year after tapering compared to their pre-tapering period.

Their study was published June 13 in JAMA Network Open.

Opioid therapy and the push to reduce the dose of pain medication

Changes in prescribing guidelines and regulatory policies driven by the rise in opioid-related deaths have led many physicians to reduce daily doses for patients on stable opioid therapy for chronic pain. The dose reduction process — called tapering — has been linked to worsened pain, symptoms of opioid withdrawal and depressed mood among some patients.

Recently, a team of UC Davis Health researchers found an increased risk of overdose and mental health crisis up to one year following dose reduction. Their research suggested that patients undergoing tapering need significant support to safely reduce or discontinue their opioids.

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