Opioid Taper: How to Wean off Opioids Safely
Last Updated: October 26, 2023
With the increasing attention paid to opioid use and overdoses over the last decade, helping individuals experiencing dependency has been brought more into focus. The potential for developing dependency exists not only for illicit use but also for those prescribed opioid medications. The overall impact of opioid use has been remarkably widespread. An estimated 11.5 million people reported misusing prescription opioids in the United States in 2016. In recent years, the rates of overdoses involving highly potent synthetic opioids like fentanyl have continued to rise rapidly. Many individuals are unaware the product they are using contains fentanyl.
As we continue to navigate this increasingly dangerous landscape, many individuals seek safe, reliable methods to stop opioid use. Choosing to plan an opioid taper can be an effective method. If you or a loved one are interested in stopping, learning more about the process and how to minimize withdrawal effects can be helpful.
What is Opioid Tapering?
Tapering the dose of a drug can be accomplished directly by slowly reducing the dosage by incremental amounts over time. This process has the potential to take months or even years, depending on various factors like the amount of time opioids have been used or whether chronic pain is present. The most common approach used by healthcare professionals assisting with a taper of a prescription opioid is to reduce the dose by 5%–20% every four weeks, with periodic pauses as necessary. A pause refers to holding at a particular dosage for longer than a month rather than increasing the amount or stopping the medication completely.
A fentanyl taper can be accomplished using similar planned percentage reductions over time if prescription products are being used. It is crucial to talk with your doctor about how to wean off fentanyl due to the potency of the medication. Do not attempt to cut a fentanyl patch in half to try to deliver a lower dose, as this can increase the risk of overdose, as some patches will release medication more quickly than intended if cut, resulting in potential toxicity.
Individuals interested in a heroin taper may be familiar with an alternative method known as titration tapering. When discussing how to wean off heroin, it is essential to note that attempting to dilute heroin at home can be dangerous due to varying potencies and a tendency to dissolve poorly in the small volumes of water intended for intravenous use. The best form of detox recommended for heroin use is medication-assisted treatment, or MAT, under the supervision of a physician. MAT proves to be much safer and more effective than alternatives.
Why Taper Off Opioids?
Using opioids has the potential to lead to dependency because of changes in brain chemistry occurring over time. The body responds to repeated use of opiates by no longer producing its own chemicals that generate effects similar to opioids. The body also builds resistance, and higher doses are required for the desired effect, whether it’s a high or pain management, which leads to a reliance upon the consistent presence of this outside source of chemicals that interact with opioid receptors. Often, this reliance on consistent use to maintain a state of normalcy leads to Opioid Use Disorder or OUD.
Removing the stigma associated with OUD is essential — this is a biological process, and quality support is crucial for those navigating these challenges. Continued use becomes an exercise focused less on getting high and more on retaining normalcy and avoiding the pain and discomfort associated with potential withdrawal. Methods of tapering slowly or with the assistance of medications focus on minimizing and managing uncomfortable and painful withdrawal symptoms. These work best when provided with psychological and social support.
Stopping opioids cold turkey or on your own can also be potentially dangerous. If proper care is offered, withdrawal is not likely to be life-threatening. Symptoms like vomiting and diarrhea can lead to the body becoming dehydrated, and electrolytes may be thrown off balance. If this is not adequately monitored and treated, this may ultimately lead to more serious conditions affecting the kidneys or potentially cause seizures. These are life-threatening complications that someone can avoid with appropriate care.
How to Taper Off Opioids
The length or approach to a taper varies between individuals and should ultimately be a shared decision between you and your doctor. Several factors can influence the approach:
- The opioid being used.
- The dose being administered.
- The length of time opioids have been used.
- Any other health conditions that must considered.
- Any other substances or medications used or will continue to be used.
Monitoring performed by a physician is important to ensure continued safety throughout the process. Medication-assisted treatment is often recommended because of its strong background in clinical research. The medications used in these instances are Suboxone, buprenorphine and methadone. The general approach is to replace a problematic opioid with one that will provide an easier taper with a less complicated withdrawal once you are ready.
Can You Taper Off Opioids Without Withdrawal?
With the help of a doctor, you may be able to slowly reduce your dose of an opioid medication incrementally over time. Doing this slowly and carefully can minimize the risks of withdrawal symptoms, but they do not disappear entirely. If you prefer to take off opioids completely rather than using an alternative opioid, medications like clonidine and lofexidine offer additional support during the process.
An important aspect of withdrawal with the potential to be overlooked by some individuals considering stopping on their own instead of seeking help is the need for psychological, emotional and social support. The skills necessary to manage anxiety and depression are crucial during recovery.
Signs of Opioid Withdrawal
Formulating a plan can help limit and ease withdrawal symptoms, but these symptoms may still occur. Working closely and communicating with your doctor will help address these:
- Nausea and vomiting.
- Rapid, shallow breathing.
- Increased heart rate.
- Increased blood pressure.
- Difficulty sleeping.
Medical Detox Treatment
The primary focus of initial medical detox is to minimize withdrawal symptoms, allowing individuals to focus more on other aspects of therapy important to long-term recovery — let the treatment process focus on withdrawal while you focus on recovery. Regardless of the speed or approach of the taper or detox method, the potential impact of anxiety, depression and any underlying mental health disorders becomes significant. Support in these areas, like individual or family counseling, meeting with groups, or a combination, can benefit recovery.
Opioid Addiction Treatment at The Recovery Village Atlanta
The detox process may feel formidable, but you should never feel like you must do this alone. The Recovery Village Atlanta offers compassionate, personalized, practical support for individuals managing opioid use disorder. Dedicated professionals monitor the medical detox process, and you are provided with your own private space.
After detox, residential programs are available and provide ongoing support as you continue your journey toward recovery. If you or someone close to you is considering help with opioid use, quality assistance is available — reach out for more information today.
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