CDC Pocket Guide: Tapering Opioids for Chronic Pain

Consider tapering to a reduced opioid dosage or tapering and discontinuing opioid therapy when your patient:

  • requests dosage reduction
  • does not have clinically meaningful improvement in pain and function (e.g., at least 30% improvement on the 3-item PEG scale)
  • is on dosages ≥ 50 MME*/day without benefit or opioids are combined with benzodiazepines
  • shows signs of substance use disorder (e.g. work or family problems related to opioid use, difficulty controlling use)
  • experiences overdose or other serious adverse event
  • shows early warning signs for overdose risk such as confusion, sedation, or slurred speech